Back and lower back pain is one of the most common medical complaints.They are in second place in terms of the number of all requests, second only to respiratory diseases.A large variety of pathologies can cause pain in the lower back, but very often it is caused by osteochondrosis of the lumbar region.How to treat such a disease, what symptoms and signs it has, will be discussed below.
Not so long ago, medical science believed that osteochondrosis in the lumbosacral region occurs only because of age-related changes that lead to wear and tear of the vertebrae and intervertebral discs.However, today the symptom of age is not exclusive;osteochondrosis of the lumbar spine is diagnosed in patients of different age groups.Today, the cut-off age is considered to be more than 25 years.
Causes of lumbar osteochondrosis
It is impossible to name the exact reason;it will almost always be the complex impact of various destructive factors, among which the most important can be identified:
- Commitment to a passive lifestylefrom the point of view of motor activity.By their own will, immobilized people, for example, spending many hours at the computer, do not receive enough useful load, which is why the "corset" muscles relax and the load on the vertebrae increases.Moreover, almost always such a time pass is accompanied by prolonged exposure to incorrect and unnatural positions.
- Problems with hormonal levels, leading to metabolic disorders, which affects the metabolism of spinal tissue in the lumbar region and contributes to destructive processes.This also includes endocrine diseases.
- The presence of congenital or acquired abnormalitieswhen the musculoskeletal system undergoes certain changes.This can be reflected in increased loads on the spine, for example, in a patient with flat feet, curvature of the legs or spine.
- Chronically increased loadsin the lower back.Here, the risks include people with certain types of occupational activities, usually associated with lifting weights.This includes professional athletes who constantly subject their bodies to maximum loads.
- Disrupted food intake and daily routine.This also includes regular exposure to stress.These factors affect metabolic processes and affect the body's periodic restoration of its strength.
Degrees of osteochondrosis of the lumbar spine
The above pathological factors gradually lead to the appearance of the disease.However, it can appear in different ways, being practically asymptomatic at the beginning or causing pain that is difficult to tolerate during the late development.Let's consider the main stages of the development of osteochondrosis:
- A situation in which the nucleus pulposus moves within the intervertebral disc.It is characterized by pain caused by irritation of the nerve roots of the fibrous ring and longitudinal ligaments.Discomfort is felt locally in the area where the defective disc is located.The pain can be either acute with shooting or constant nagging.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the spinal elements in this area increases, they become unstable in relation to each other.To eliminate these pathological manifestations, it is necessary to constantly keep the muscles of this area tense, which eventually leads to chronic fatigue in the lower back.
- Then, a breakthrough occurs in the annulus fibrosus, which causes the nucleus to move beyond the disc border, forming an intervertebral hernia.Such a case will be accompanied by compression of the nerve endings, which is called "radicular syndrome".
- The next degree of osteochondrosis of the lumbosacral region occurs with severe deformation of the spine in this part.Mobility problems appear, but the pain syndrome, surprisingly, decreases at this stage.However, you should not rejoice;this does not mean that the disease is going away.
- The last degree is characterized by the pathological growth of bone tissue and a general deterioration of health.
Based on the degree of lumbar osteochondrosis, certain treatment methods are used.
Symptoms of osteochondrosis in the lower back
The main symptom is the combat syndrome in the lumbar spine.At the same time, pain sensations, the area of their localization and the direction in which they spread may change.This happens due to the fact that, based on the degree of damage to the intervertebral disc and surrounding tissues, some nerve receptors are irritated.In addition, the presence of an extension or the hernia itself, the direction of its extension and many other factors play a role.
The main symptoms of osteochondrosis of the lumbar spine include:
- The presence of pain in the lower back, which tends to intensify with sudden movements or, conversely, standing without changing position for a long time.The pain decreases if you take a horizontal position.
- In addition, weakness in the area of the body below the abdomen, including the lower extremities, is likely, as well as a sharp tendon reflex in the leg.
- There is a high probability of curvature in the lumbar spine.There is a classification of such curvatures, for example, when the emphasis is on the right or left side, they speak of scoliosis, lordosis is the situation of bending forward, and kyphosis is the case when the natural curve of the waist is, so to speak, softened.
- With a serious degree of development of the disease, the narrowing of the canals of the spinal cord is possible, which can cause its dysfunction and lead to uncontrolled urination and defecation.
Additional symptoms include:
- The presence of numbness and "cooling" of the skin of the lower back and buttocks.
- Cracked, dry and blue skin in the same places.
- Impaired urination.
- Erection problems.
The presence of these symptoms should alert a person;they should not be given up, this will only lead to greater neglect.In this case, you should definitely consult a doctor for accurate diagnosis and treatment.By the way, treatment can be either in a hospital setting or at home, but more on that a little later.
Diagnosis of the disease
When making a diagnosis, it is important to understand the degree to which the disease has progressed.The easiest way is palpation in the lumbar region to identify areas of pain.Typically, this method is not very informative, and in addition, examinations are performed that give a more detailed clinical picture:
- With radiography, a cheap and widespread method, it is possible to assess the condition of the spine as a whole and of individual vertebrae, for example the lumbar region in question.The technique is not very precise;it only allows us to understand indirectly how intact the intervertebral discs and spinal canals are.
- Computed tomographya more accurate method that allows you to assess the level of damage to the discs between the vertebrae, nerve roots and canals with the spinal cord.
- Magnetic resonance imagingthe most accurate method, gives a complete picture of the lesion in detail, but it is quite expensive and inaccessible.
It should be noted that the diagnostic process is very important, since all the details of the developed osteochondrosis are important for the doctor when prescribing treatment tactics.
Complications of osteochondrosis
The main complications of the pathology are hernias and protrusions, which inevitably occur if treatment is neglected and the development of the disease is left to chance.Other complications may include:
- Inflammation of the sciatic nerve.
- Spondyloarthrosis.
- Schmorl's hernia.
- Spondylosis.
- Problems caused by compression of the spinal canal.
- Functional disorders in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When diagnosed with osteochondrosis of the lumbar spine, a wide range of therapy is required, the main aspects of which will be:
- Application of moderate loads.
- Special medicines.
- Traction of the spine.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of "treatment" for osteochondrosis means:
- Suppression of inflammation.
- Relief of pain syndrome.
- Complex for strengthening the middle and adjacent muscle groups.
- Relief from chronic muscle tension.
- Increased functionality of organs in the pelvis.
- Normalization of blood circulation and metabolism in the pathological area.
Treatment with medications
A similar approach to the treatment of lumbar osteochondrosis includes taking medications, injections of special drugs, and the use of ointments and gels for external use.The main task of such drugs is to neutralize pain and inflammation.
Based on the degree of osteochondrosis of the spine in the lumbar region, the doctor may prescribe the following drugs:
- Analgesics that have an analgesic effect.
- Anti-inflammatory drugs of non-steroidal origin.
- For muscle spasms, antispasmodics.
- Medicines for the restoration of cartilage tissue, called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in traditional medicine.
- For severe pathologies, when the above means do not help, turn to corticosteroids.
- Vitamin complexes.
In addition to these medications, medications are prescribed in tablets, the purpose of which is to calm the nervous system and fight stress and depression.
Physiotherapy treatment for lumbar osteochondrosis
The treatment process is rarely limited to just taking pills.The pathology in question cannot be cured without stimulating the restoration processes of the spine.For these purposes, a wide range of physiotherapeutic procedures are used, the most popular of which are:
- Phonophoresis.
- Diadynamic current therapy.
- Laser therapy.
In addition, useful loads should be given to the spine by stretching it at the same time.Different types of therapeutic massages are ideal for this.It should be remembered that massage is used only when the pain is relieved.As a rule, it is performed as a restorative measure when the process of remission of the disease has begun, or in chronic osteochondrosis.After a massage, the muscles overloaded by the disease relax well;its effect will increase significantly when heated at the same time, for example in a bath or sauna.In the latter case, we will achieve the maximum effect due to additional stimulation of blood circulation in the area of pathology and adjacent areas.
Another method of physical therapy is manual therapy.Its advantages are generally the same as those of massage, but in addition, with the help of such techniques, a specialist is able to return the displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercises are also used as a restorative and preventive measure during the period when pain and inflammation have already subsided.The key to the high effectiveness of therapeutic exercises is the regularity of the exercises;in this case, the damaged area will constantly receive the physical activity necessary for self-generation of new tissue and recovery.
Surgical operations for lumbar osteochondrosis
Surgery is the last resort, which is prescribed for serious complications.The most common of them is the intervertebral hernia, when the so-called "discectomy" or removal of the affected intervertebral disc is performed.The operation is very effective, however, being a last measure, it is prescribed only if other methods of therapy have failed for more than 6 months.Modern medicine also offers less traumatic methods for performing such an operation, for example, microsurgical or endoscopic methods.