Osteochondrosis of the lumbar spine - signs, diagnosis and treatment

Lumbar osteochondrosis is a common disease of the musculoskeletal system.The lumbar spinal column is most susceptible to injuries due to good mobility.Also, with improper and prolonged seats in combination with a low -acting lifestyle, accelerated wear of cartilage tissue occurs, which ultimately leads to osteochondrosis.

You should know how to recognize the first signs in order to receive qualified medical care in a timely manner.

Brief information about osteochondrosis of the lumbosacral spine

Back pain is one of the most common complaints of patients with a traumatologist.The second name of the syndrome is Dorsalgia of the intervertebral discs.According to statistics, on average 8 out of 10 people during their lives at least once complained about discomfort in the lumbar zone.Approximately a third of the patients who have seen the doctor, the pain syndrome acquires a persistent pathological character, causing severe discomfort and painful condition in the patient.Long back pain can not only cause physical torment, but also provoke mental instability.

Since cartilage fabric loses its strength and elasticity, it begins to gradually become thinner and collapse.As a result, cracks occur in fibrous rings of the intervertebral discs.Over time, under pressure, the fibrous ring stretches, protrudes and bursts.If the contents of the fibrous ring are a pulpic core, it goes out, a hernia forms.For this reason, osteochondrosis increases the chances of the appearance of such formidable complications.

The causes of the occurrence of the disease

In most cases, osteochondrosis has a hereditary nature.It is proved that if direct relatives suffered from degenerative diseases of the musculoskeletal system, then their children more often encounter pathologies of the spine.

Other cases have extrovertebral reasons:

1. Maintaining improper posture.
2. Excessive muscle overvoltage associated with large physical exertion at work or when playing sports.
3. Incorrect and frequent weight lifting.
4. One of the most common reasons is hypodynamia.Lack of movement and minimal physical activity often leads to problems with the spine than playing sports.
5. Previously transferred inflammatory infections - tuberculosis or osteomyelitis, contribute to the manifestation of degenerative processes in the spine.In this case, osteochondrosis will have an infectious nature, and be a complication.
6. Hormonal perestroika can provoke a lumbosacral sacral osteochondrosis.This phenomenon is more often associated with certain age periods.A frequent example is to enter menopause.Upon the cessation of monthly cycles, a woman has a drop in sexual steroid hormones, due to which calcium practically ceases to be absorbed by the body.The reserves in the bones are washed intensively.As a result, if you do not put a woman in the GZT, she will earn not only osteochondrosis of the lower back, but also osteoporosis.The risk of osteochondrosis increases with the frequent use of synthetic glucocorticosteroids.Risk is increased during puberty with a lack of nutrition, with exhausting physical exertion in combination with a hard diet and when old age occurs.
7. The presence of congenital pathologies of the ridge, including an anomaly of tropism.
8. Flat feet and scoliosis.
9. The weak structure of the bones caused by a deficit in nutrition or against the background of amenorrhea in women.
10. Premature wear of the vertebrates and joints.
11. Premorbid hypermobility of the mobile spine, which significantly increases the risk of injury.
12. Weak abdominal muscles.
13. The presence of rare pathologies, including a narrow spinal canal, peridural fusion, spondylolist, oncology or tumor of the spine, neuromyositis.
14. The presence of endocrine disorders - obesity and uncompensated hypothyroidism.
15. Previously suffered injuries of the ridge, ligaments, joints, tendons.
16. Poor power and frequent psycho -emotional stresses.
17. Degenerative age -related changes.

There are also certain risk groups associated with harmful professional activities.Examples are builders, movers, computer scientists, waiters, teachers.To minimize the risk of such diseases, you need to correctly distribute the load on the back and engage in moderate-active physical activity.

Symptoms of lumbar osteochondrosis

The disease has many symptoms, so separately it is necessary to highlight the classification according to the type of pain:

1. Ischemic syndromeassociated with compression of the arteries passing through the vertebrae.As a result of the occurrence, a persistent deterioration in blood circulation appears, due to which the nutrition is disturbed in the lower extremities.It is possible to increase blood pressure.
2. Vertebrate syndromeassociated with deformations that occur in nerves and vessels.With prolonged negative effects, posture changes, the back is stooping, the gait changes, and the muscles without physical activity are atrophy.As a result, the patient begins to experience severe pain.
3. Static syndrome.Pathological mobility develops in the vertebrae, which can occur kyphosis or lordosis.During the development of pathology, the spine is gradually deformation, since in addition to curvature in the vertebrae, improper muscle fixation in the affected areas occurs.The consequences of a static syndrome - the back is twisted, and a person is no longer able to straighten it on his own.
4. Neurological syndromeassociated with the pinching of nerve roots.If pressure occurs on the nerve endings, the patient’s sensitivity decreases, the appearance of weakness in the limbs may occur.In severe cases, paralysis, chills and complete loss of conductivity are noted against the background of damage to the nerve fibers.

General symptoms of osteochondrosis of the lumbar spine include the following manifestations:

1. Strong pains at the bottom of the back, including the entire lumbar region with possible return to the sacrum.
2. With the development of radicular syndrome, there are sharp pains that give bastards to the lower limbs.Legs usually capture cramps.In the fingers there is numbness and paresthesia.Less often, the pain gives to his hands.
3. Irradiation of kidney pain is possible.The patient can complain about problems from the urinary system, which are not confirmed during the diagnosis.
4. The patient is tormented by a bad dream due to discomfort in the lumbar region.
5. The patient feels tension and fatigue in the lumbar region.
6. When turning the back and inclinations, stiffness and tension are felt.
7. Feet occurs in the back periodically.
8. After minor physical activity, the patient feels severe fatigue.There is also chronic fatigue in everyday life.
9. With further progression of the disease, the patient has pain at rest in the lumbar region.
10. The limbs often go numb, and the patient often has a pathological crunch in the back.
11. Violation of the motor function due to discomfort at the bottom of the back.
12. Muscle cramps and spasms.
13. Dizziness and headaches.
14. Reducing the tone of the muscles of the back and lower extremities.

Any similar symptoms require an appeal to the doctor.There are also specific signs associated with gender.Men have problems in the genitourinary sphere, which can negatively affect potency.Women have severe pain in the perineum and pelvis, which also indicates damage to the nerve endings.In advanced cases, prolapse of the internal organs occurs, including the uterus and appendages.This is due to strong atrophic processes in the muscles that support the spine.

Varieties of syndromes and symptoms of osteochondrosis of the lumbar spine

By the type and nature of pain, such pathological conditions share:

1. Lumbago- It is characterized by an acute state.Characteristic signs are the inability to move from the pain that occurs against the background of the bastards.This condition more often develops against the background of muscle atrophy, injuries, pinching of nerve roots and intervertebral discs.
2. Lumbalgia- pathology characterized by long and aching pain.More often lumbalgia occurs against the background of osteochondrosis, hernia, spondylosis or protrusion.With stretching the ligamentous apparatus, the syndrome is more common.
3. Sciatica.This type of pain syndrome is characteristic of the lumbosacral zone.The syndrome is often confused with Ishias, which is characterized by a firing pain caused by a pinching of nerve roots.The pain syndrome is more often associated with a pinching of the sciatic nerve, which significantly worsens mobility in the lumbar region.The patient cannot bend normally, since the mobility of the lumbar region worsens.It is also hard to walk and sit normally.Pinching the sciatic nerve leads to another unpleasant deterioration - spasm of the pear -shaped muscle.As a result, a person has shots from the back to the calf muscles passing through the thigh.The gait becomes lame, socks of the legs turn to the sides, and in the buttock you feel pain when walking, running and sitting.A comprehensive approach in treatment is required.
4. Discogenic changesassociated with the progression of dorsopathy.The first sign of such a deterioration is the loss of sensitivity and numbness in the lower extremities.The back, buttocks, hips and lower abdomen suffers.All these zones are permeated by constant discomfort.With a strong deterioration, signs of an inflammatory process occur - body temperature rises, weakness occurs in the body, urinary incontinence appears.The patient also worsens appetite, which leads to a decrease in body weight.In this situation, an integrated approach in the treatment of the condition is also required.
5. RadiculopathyIt is also associated with the limitation of the motor skill of the spine and the clamping of the nerve endings.As a result of the occurrence of this type of pain syndrome, the patient begins to feel pain in the lower body, a decrease or violation of motor reflexes.There is a deterioration in the mobility of the joints and a decrease in muscle tone against a background of compression due to radiculitis.

All of the above pain syndromes require urgent treatment, starting at the initial stages of manifestations.Indeed, over time, pathology is aggravated, due to which the course of the disease leads to a strong deterioration in the quality of life.

Osteochondrosis of the lumbar spine - development stages

The general classification of the disease in stages includes such degrees of development of osteochondrosis of the lumbar:

1. The first degree does not cause any physiological deteriorations from the spine.The patient feels well and does not suspect the presence of problems with the spine.At the initial stage, active destructive processes arise.The pulpoose core changes its position, gradually seeping through the microcracks of the fibrous ring.Earlier in the article it was mentioned that before the occurrence of the disease, the patient has a violation of metabolic processes, due to which the cartilage shell weakens and is covered with microcracks.As a result, over time, irritation of the nerve endings appears, due to which the patient may feel the first signs of discomfort in the lumbar region.
2. Osteochondrosis of the second stage is characterized by the appearance of signs of instability of the lumbar region.There are dynamic displacements in the vertebrae, relative to the overlying and underlying section.The patient has signs of compression syndrome and reflex disorders.
3. In the patient, in the event 3 of the stage of pathology, deteriorations associated with protruding the contents of the fibrous ring outward already occur.Propes, prolapse or hernia appear.In the event of the 3rd stage of the pathology, the roots of the spinal canal and blood vessels are squeezed.At this stage, severe pains associated with pinches and inflammations already occur.Strong mobility is also limited, shelters arise in the lower limbs.
4. The terminal stage is the fourth.At this stage, irreparable pathophysiological changes already arise.The patient has pathologies of the bone system associated with the growth of bone-cherry vertebral bodies.As a result, response compensatory reactions arise - the load is transferred to other, weaker vertebrates.Stock, limitation of mobility in the amplitude of the spine.Pathological bone growths press on the vascular channel and nerve endings, which significantly burdens the symptomatic course of pathology.

Lumbar osteochondrosis - diagnosis

When the patient gets to the doctor, he prescribes a number of laboratory examinations on the basis of the assembled history to identify osteochondrosis of the lumbar sacrum of the spine:

1. X -ray.This is a basic analysis that allows you to assess the condition of the spine in general terms.X -ray will not show small and initial pathological changes, but will identify gross violations in bone tissue.If the picture shows signs of erasing vertebrates or darkening that do not correspond to normal size, other studies are necessary.
2. Computed tomography.This is a more advanced version of the X -ray picture, which allows you to see the smallest negative changes in bone tissue at the destruction site, as the pictures are taken in a three -dimensional image.
3. Magnetic resonance tomography.This type of diagnosis is close to CT, but allows you to better consider soft tissues.MRI distinguishes between deteriorations of osteochondrosis, including hernias and protrusion.This type of diagnosis is sufficient to accurately make a diagnosis associated with degenerative destruction of the bone-cheap tissue.
4. Conducting laboratory testsBased on biomaterial.Patients often pass a general blood and urine test in order to control the basic indicators.These data allow you to superficially assess the patient's health status.
5. Delivery of rheumatological samples.It is necessary to analyze in order to eliminate the rheumatoid nature of the pathology.

After inspection and conduct of the necessary tests, they make a final diagnosis.

Treatment of osteochondrosis of the lumbar

In the treatment of pathology, an integrated approach is needed.At 1-2 stages, conservative treatment with the use of medicines and physiotherapy in the recovery period is used.In the presence of 3 or 4 stages, if the patient has serious indicators of health deterioration, surgical intervention is necessary.

Drug treatment of the pathological process

In case of damage to the intervertebral discs, which arose against the background of osteochondrosis of the lumbosacral department, the use of an extensive list of medicines is shown.Some products serve for symptomatic therapy, others to maintain health.

What drugs prescribe:

1. Nonsteroidal anti -inflammatory drugs, analgesics.These drugs greatly facilitate the patient's condition, especially in the acute period.Thanks to the pronounced effect of this type of drugs, it is possible to quickly calm down the pain within 1-2 days.Typically, patients are prescribed by NSAIDs of the selective type of action, since they less damage the mucous membrane of the stomach.If the indifferent old NSAIDs cannot be used for more than 5 days, then the new generation drugs can be drunk for 2-3 weeks without fear of the consequences for a healthy gastrointestinal tract.In the presence of gastritis or ulcers, it is better to be safe and use gastroprotectors, proton pump inhibitors.
2. Musorelaxants- drugs designed to eliminate painful muscle cramps.With osteochondrosis, an improper distribution of the load on the muscle corset associated with the weakness of the spine occurs.As a result, some muscles are clamped, while others are in the hypotonus.To relieve painful spasm, muscle relaxation is prescribed.The duration of the course of treatment and the scheme for taking pills are selected by the attending physician.
3. Neurotropic vitamins.Such means include Biamine Vitamins, Tiamin, Cyanocobalamin and Pyridoxine.With combined use B1, B6 and B12 in large dosages, an analgesic effect occurs.The components positively affect the nerve endings, nourishing them.These vitamins also participate in the construction of myelin shells covering the nerves.Such drugs are mainly prescribed for radicular syndrome, when it is necessary to relieve pain associated with pinches of nerves.For 2-3 weeks, injection agents are used, and then switch to oral forms of release.
4. Chondroprotectors.These drugs have protective properties in relation to cartilage.If there are clear signs of cartilage degeneration, it is necessary to prescribe chondroprotectors with a long course.First, injecting agents are used for 2-3 months, and then switch to tablets.The minimum course of use is six months with a break of several months.The current components in the composition are chondroitin sulfate and glucoseamin hydrochloride.The reception and dosage schemes are selected individually.
5. Calcium in combination with vitamin D3.These components serve to strengthen bone tissue.With age, due to bone wear, malnutrition and hormonal deficiency, the brittle of bones is enhanced.The main building material is calcium.Without it, it is impossible to get a strong bone corset.In order for calcium preparations to be absorbed, it is necessary to take vitamin D3.To avoid the deficiency of cholecalciferol, it is necessary to regularly visit the sun in the summer, and in winter to take additional vitamins.
6. Complex polyvitamins.There are research data that the constant intake of vitamins in natural or synthetic form in physiological doses strengthens the immunity during seasonal exacerbations of SARS, acute respiratory infections.Persons with diseases of the lumbosacral spine should carefully monitor their own health.
7. Blockade with anestheticsThey are carried out with a poorly cut pain syndrome using NSAIDs.Intra -articular injections of corticosteroids that relate to blockades are also effective.Such means help to calm down inflammation, which accelerates recovery in the acute period.The performance of the blockade should be carried out by a highly qualified doctor with extensive experience in their use.It is advisable to carry out blockade under the control of ultrasound so as not to get into other parts of the spine.Such treatment methods will help to quickly get rid of chronic pain.
8. Special ointments and gels.With the help of local funds, you can also successfully fight the chronic pain syndrome of moderate and weak power.Different products are cooled or warmed up, which generally allows the use of external drugs regularly.The use of drugs on the surface of the skin allows you to use them for a long time.Such drugs are practically not absorbed into systemic bloodstream, so they do not cause side effects.It is important to pay attention to the condition of the skin after applying the medicine.If there is a rash or itching, you need to cancel the drug.

Homeopathy or antispasmodics can also be prescribed.The diagram of taking medications is determined by the doctor on an individual basis.

Conservative non -drug methods of treatment

In the recovery period, physiotherapeutic procedures must be used that help improve blood circulation and normalize metabolic processes in affected tissues.Active recovery methods are used exclusively after stopping acute pain.Supporting conservative treatment softens the chronic course of the disease, which prevents exacerbation attacks.

Methods of active rehabilitation include:

1. Conducting physiotherapy physical education.With the development of lumbar osteochondrosis, special exercises are needed that improve blood flow that levels posture and support muscles in tone.LFK at first must be carried out under the supervision of an instructor, including safety rules.Exercises are performed in the standing position, sitting or lying, depending on the assigned complex by a specialist.If the patient is experienced, he can conduct gymnastics at home.You should not ignore the useful part of the lesson - warm -up and hitch.After a good warm -up, the muscles are protected from tears and sprains.The last stage of execution accelerates the recovery processes in muscles.With regular exercises, the muscles become strong, due to which the pain in the back weakens.
2. Massage- A way to relax tense muscle tissue in contact conditions.A specialist with the help of hands improves blood flow in muscles, which allows you to remove strong overvoltage.Massages in combination with muscle relaxants are most effective.These drugs eliminate spasm and spasticity.Additional stimulation with hands potentiates the effect of the drug.It is recommended to visit the masseur several times a year in courses so that a steady effect occurs.
3. Manual therapy.Using this method of exposure, it is possible to unclench the muscles, not taking into account the degree of their resistance.Unlike massage, this method is violent, albeit effective.With a neglected lumbar osteochondrosis, it is dangerous to use manual treatment practices if the specialist is not experienced enough.Before contacting a manual therapist, you need to familiarize yourself with the list of contraindications, including hypertension, heart disease and the presence of a hernia in the lumbar region.
4. Physiotherapeutic procedures.With the help of physiotherapy, it is possible to improve local blood flow in the affected area without affecting other zones of the back.The essence of physiotherapy is simple: they combine hardware treatment methods and drugs.Examples are electrophoresis.Under the influence of a laser of a certain frequency, medicines are administered through the skin.More often use injection vitamins of group B. The device allows you to get into the skin of the skin to medicines without creating a systemic effect on the body.Magnetotherapy and shock wave therapy are also related to physiotherapeutic methods.Radiated frequencies accelerate the regeneration processes in the joints and ligaments without causing side effects.

As part of complex treatment, acupuncture, hirudotherapy or homeopathy can be prescribed.

When surgical intervention is performed

Operations are necessary in advanced cases when the patient is tormented by serious neurological syndromes that have arisen the background of lumbar osteochondrosis.If the patient has a complication in the form of a hernia, the limbs began to be taken away, and the sensitivity of the intestines or bladder was disturbed, it is urgently hospitalized.In this case, the operation is carried out according to life indicators.

There are also relative indications for surgery.Examples are frequent numbness of the limbs, constant discomfort in the back, which is not amenable to conservative treatment, partial loss of sensitivity in the fingers.In this case, you can independently decide on surgical treatment.

Lumbar osteochondrosis is a serious pathology that requires an integrated approach to therapy.At the initial stages, medicines and physiotherapy are prescribed.If the disease is rapidly progressing, surgery may be required.