Osteochondrosis of the lumbar spine is a pathological change in the cartilage and bone tissue of the intervertebral disc in the lumbosacral spine. These changes can occur naturally or as a result of an unhealthy lifestyle. In old age, the process of involution of bone and cartilage tissue begins in everyone. But when this phenomenon is premature (appears in middle -aged people), then we are talking about the pathological process of the skeletal system. Pathology affects equally both men and women over 30 years of age.
Lumbar osteochondrosis is the most well -known and common spinal disease, which is indicated by severe pain in the lumbar region. The disease develops as a result of metabolic disorders, which lead to inadequate nutrition of cartilage and bone tissue, and waste products accumulated in bone cells. This leads to intervertebral disc pathology. In addition, their thickness and flexibility change, and then growths in the form of osteophytes (growths of bone tissue, leading to narrowing of holes for nerve endings) form on the vertebrae.
Causes of the development of osteochondrosis of the lumbar spine
Lumbar osteochondrosis occurs 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 in a chair or lifting weights.
Since this anatomical site takes maximum load, its structure is very strong and reliable. The lumbar region consists of five vertebrae and connects the ribs to the sacrum. Among them is the intervertebral disc, which provides flexibility and mobility of the spine. In contrast, the intervertebral disc consists of a jelly -like nucleus, located inside the hard fibrous annulus. As osteochondrosis develops, the normal nutrition of the discs is disrupted, as a result of which they become thinner, lose elasticity, and the distance between them decreases. As a result, nerve roots are violated, leading to severe pain and even disability.
Therefore, the reasons for the development of this pathology are:
- spinal cord injuries;
- diseases of the endocrine, digestive and cardiovascular systems;
- intense physical activity (lifting weights, running vigorously);
- sedentary lifestyle;
- damage to the hormonal system;
- Flat feet;
- intervertebral disc anomalies;
- aged;
- inflammatory diseases of the joints, such as rheumatoid arthritis.
Risk factors for the development of the disease are:
- crouching and poor posture;
- wrong lifestyle;
- unhealthy diet, obesity;
- being in the wrong posture for a long time;
- hereditary factors;
- pressure;
- hypothermia.
The main symptom of this 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 spasm of the back muscles;
- sudden painful sensation (lumbago) after body hypothermia;
- violation of sensitivity in the buttocks, thighs, lower legs and feet;
- paresis in the legs;
- cold feet;
- leg artery spasm;
- excessive sweating;
- dryness and peeling of the skin in the sore spot.
Osteochondrosis of the lumbar spine can be exacerbated by any awkward movement, for example, when moving or rotating the body to the side. In this case, pain is observed not only in the lower back, but also in the legs. There is also a strong spasm from the lumbar spasm, because 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 or herself where the pain subsides.
One of the complications of lumbar spine osteochondrosis is damage to the genitourinary system. Occasionally there is an increase in urination and discomfort in the kidney area. Inflammation of the sciatic nerve and lumbodynia (pain in the lower back) can accompany the disease.
Stages of lumbar spine osteochondrosis
Unfortunately, osteochondrosis is an incurable disease, and the process of intervertebral disc destruction is irreversible. There are four stages in the development of osteochondrosis:
- The first degree, where the jelly -like nuclei inside the disk change and move.
- The second stage is the period of destruction of the fibrous annulus in the disc;
- The third stage, in which the fibrous annulus ruptures and a jelly -like nucleus leaves it, leading to the formation of a herniated disc.
- The fourth stage is the period of development of the vertebral degenerative process with the involvement of the intervertebral joints and ligaments. Arthrosis of the intervertebral joint (spondyloarthrosis) develops.
First degree
It is characterized by a painful sensation due to irritation of nerve endings located in the annulus fibrosus and longitudinal ligaments. The patient feels pain and discomfort in the affected part of the disc. The pain can be sharp, acute or dull, permanent and localized in the lumbosacral segment. Often it exits to the feet, and sometimes it is only felt in the feet.
Irritation of nerve endings leads to the development of reflex syndrome. For this reason, one does not always feel pain in the problem area, but far beyond it. Also, there is a violation of the robot internal organs, the occurrence of reflex muscle spasms; circulatory disorders of the limbs and ligaments. Violation of blood circulation and nutrition of tendons and ligaments, leading to pain and induration in places attached to the bones.
second degree
At this stage, there is characteristic instability and an increase in vertebral mobility, which leads to constant 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 "hurts", and the patient does not understand why.
third degree
It is characterized by prolapse of disc fragments, which is indicated by compression of the nerve root. During this period, there is a violation of sensitivity in the conservation zone 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 were observed. The zone in which the above -mentioned changes are observed clearly indicates the location of the spinal lesion. The characteristic manifestation of the third degree is the appearance of Lasegue symptoms. It manifests itself as follows: when the patient lies on his back, legs straight up, there is severe pain in the lumbar region, which spreads along the back of the raised leg. When the leg is bent to the knee, the pain immediately subsides.
When fragments of the intervertebral disc fall into the lumen of the spinal canal, damage to the spinal cord occurs. Another syndrome, called ponytail, is indicated by impaired sensitivity and motor function of the legs, as well as the pelvic and bladder organs.
Fourth grade
This period is characterized by loss of pain and restoration of function of the musculoskeletal system. However, at the same time, there are limitations of motor function. The spine, it seems, becomes woody, when disc fibrosis develops and all its elements are replaced by dense scar tissue. At the same time, the ligaments and intervertebral joints are involved in the inflammatory process, and different stages of the disease are also observed, which are indicated by symptomatic polymorphisms.
How to treat osteochondrosis of the lumbar spine
The treatment of lumbar spine osteochondrosis is a very long and continuous process. And most importantly, for the success of the treatment of the disease, much depends on the person himself. After all, he needs to radically change his lifestyle and get rid of a lot of daily habits, as well as take care of his health for the rest of his life.
In the opposite case, even successful drug treatment will not be able to completely eliminate the spinal deformity. In addition, after temporary improvement, symptoms will return with new intensity and treatment will need to be restarted. Although sometimes, even with adherence to a regime of physical activity, attacks of osteochondrosis occur.
Therefore, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug treatment;
- not drugs;
- surgery.
Conservative drug treatment
Since spinal osteochondrosis 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 exacerbation, bed rest is recommended. This is sometimes more effective than medication.
To relieve the symptoms of inflammation, use:
- NSAIDs (non-steroidal anti-inflammatory drugs). Drugs of this group are effective in relieving pain and inflammation in the vertebrae. The drug can be in the form of 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).
- Sedative. They are necessary to eliminate associated reflexogenic and psychogenic disorders.
- Anticonvulsant. Eliminate inadvertent skeletal muscle contraction.
- Antidepressants. Drugs of this group affect the level of neurotransmitters, as a result, the patient's mood improves, melancholy, anxiety and emotional stress disappear.
- Diuretics. They are needed 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 discs and vertebral joints.
In acute attacks, novocaine blockade is prescribed (introduction of anesthetic drugs directly into the affected area).
The symptoms of lumbar osteochondrosis in women present themselves differently than in men. In women, the menstrual cycle can be disrupted, as well as gynecological diseases can develop: inflammation of the ovaries and uterus (endometritis). Reproductive damage 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 the symptoms that prevent a person from leading a quality lifestyle.
The following treatment methods are used at home:
- Diet. Often the cause of osteochondrosis is cholesterol accumulation and loss of vascular elasticity. To restore the condition, it is necessary to adhere to a low -fat diet. Also exclude high -cholesterol foods from the diet: eggs, pork, rich soups, chicken skin. Eliminate alcohol and nicotine completely, reduce consumption of strong coffee and tea. They lead to vasospasm.
- Restoration of blood supply in the lumbar region. To do this, use both rubbing with medical ointments and compresses, and physiotherapy exercises, which can be done at home.
- Orthopedic sleeping aids. Since the spine is the axis of the human body, which experiences 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.