Lumbar osteochondrosis is a degenerative and dystrophic disease of the lower back. As the disease progresses, the intervertebral discs are most affected, and the damage spreads to the joint surfaces, ligaments, and vertebrae.
The share of osteochondrosis of the spine is 80% of all diseases of the peripheral nervous system. Osteochondrosis of the spine is 60-80% of the time. At least 7 out of 10 people experience regular back pain throughout their lives. Periods of exacerbation occur on average between 3 and 16 days a year. However, the disease can and should be treated to maintain a high standard of living and musculoskeletal health. Why this disease develops, how it manifests itself, what should be the treatment of osteochondrosis of the lumbar spine.
What is osteochondrosis
Osteochondrosis is a chronic disease of the spine, accompanied by changes in the structure of the intervertebral discs (destruction) and a decrease in volume (dystrophy). They begin to enter the spinal cord and squeeze the blood vessels. In addition, the disease is characterized by the destruction of the facet joints between the spinous processes of the vertebrae.
Osteochondrosis also causes osteophytes. This is the name of pathological growths that are the result of marginal bone growth. Facilitates high loads that lead to disruption and deformation of calcium metabolism in the vertebrae.
Attention! Lumbar osteochondrosis is generally characterized by all the pathological processes inherent in osteochondrosis. However, they only affect the lumbar spine, which covers 5 vertebrae.
Developmental causes and risk factors
To understand the causes of lumbar osteochondrosis, you need to know the structure of the spine. It is a column of vertebrae connected to each other by intervertebral discs and ligaments. The hollow inside creates an empty channel. Inside is a spinal cord with roots between the two pairs of vertebrae.
When a person bends, the spine bends. At the point of curvature, the intervertebral discs are compressed and the nuclei are removed. This reduces the pressure on the spine during exercise. Thus, the intervertebral disc is a biological shock absorber. Osteochondrosis develops when the shock absorber ceases to perform a function.
The following factors contribute to the development of pathology:
- sedentary or very hard work. When sitting, the muscles of the corset relax, which increases the load on the spine. Weight lifting leads to this.
- Hypodynamics. In people with a sedentary lifestyle, the muscular corset is not developed enough to keep the spine in the right position.
- Overweight. Excess weight puts pressure on the spine and puts a lot of strain on it.
- Endocrine diseases. Hormones affect metabolic substances, including subcutaneous metabolism. Hormonal imbalance can lead to a violation of calcium metabolism.
- Wrong food. Insufficient intake of vitamins, minerals and proteins in the diet disrupts the nutrition of the spine and causes changes in the tissues.
- Pathology of the musculoskeletal system. Osteochondrosis can occur against the background of straight legs, injuries and curvature of the spine.
- Genetic predisposition. If you have close relatives, the risk of developing osteochondrosis increases.
- Age-related changes. With age, the elasticity and mobility of the spine decreases.
Osteochondrosis of the spine is more common in men. This is because their work is often associated with heavy physical labor. Men are also exposed to heavy loads during strength training in the gym.
Symptoms of lumbar osteochondrosis
Pain is the main symptom of the disease. Its nature, location, and direction of propagation are determined by a receptor compressed in the spinal cord. In general, patients complain of excruciating pain that is exacerbated by a change in body position over a long period of time and a lack of change in sudden movements. With lumbar osteochondrosis, it often spreads to the leg, sacrum or groin. Pain decreases in the horizontal position.
Other possible symptoms of lumbar osteochondrosis:
- Feeling of tension during lumbar flexion and extension. It is caused by the displacement of the spinal cord.
- Feeling of weakness in the legs. They may have no tendon reflexes. This is because the nerve fibers that send signals from the brain to the lower extremities are compressed.
- Curvature to the side (scoliosis) or forward (lordosis) that corrects the natural curves of the waist (kyphosis).
- Involuntary urination and defecation (if the spinal cord is compressed). For the same reason, erections can be disturbed in men.
- Cold back. Buttons can also get cold. This occurs with lumbosacral osteochondrosis, the symptoms and treatment of which are similar to the pathology localized only in the lumbar region.
- Sensory disorders in the affected area. They can last from a few minutes to several hours. Sensitivity may increase, decrease or disappear. Perhaps the development of paresthesia - tingling and crawling.
Lumbar osteochondrosis is a tricky disease that we will analyze the symptoms and treatment of in this article. It starts with anxiety and mild pain. However, they are ignored because they pass quickly after the rest. Over the years, the pathology progresses, the symptoms intensify. And only when the pain is unbearable, patients go to the doctor.
Degrees of lumbar osteochondrosis
The development of lumbar osteochondrosis consists of 4 stages:
- The first stage is characterized by the displacement of the nucleus of the intervertebral disc. It is accompanied by a slight dull pain in the lower back, aggravated by movement. There may be a short tingling sensation in the back and thighs.
- In the second stage, the fibrous ring of the intervertebral disc is destroyed, which causes the vertebrae to converge. They squeeze the nerve endings, which cause severe pain during walking. It can spread to the hips, thighs and lower legs. Bending over can cause a burning sensation, sometimes a feeling of coldness.
- In the third stage, the complete destruction of the ring fibrosis occurs. Protrusions (hernias) appear - protrusions of intervertebral discs in the spinal cord. The lumbar vertebrae are deformed. The pain is always felt, but weaker at rest.
- In the final stage, osteophytes are formed, the cartilage tissue of the spine is destroyed. The pain then subsides, then worsens with renewed vigor. Body movements are limited.
Early diagnosis of lumbar osteochondrosis is very important, as treatment of the spine and its symptoms are closely related. The less pathological the manifestation, the more effective the treatment. Therefore, in any unexplained situation you should consult a doctor for back pain and back pain.
If there is no treatment for 1st and 2nd degree osteochondrosis of the spine, an intervertebral hernia develops. This indicates that the disease is in its final stages and threatens the development of complications as follows.
- sciatic nerve inflammation;
- arthrosis of the intervertebral joints (destruction);
- destruction of intervertebral disc ring fibrosis;
- narrowing of the intervertebral canal;
- dysfunction of the spinal cord as a result of compression;
- cauda equina syndrome;
- Schmorl hernia;
- lameness and rigidity.
Properly chosen treatment will help prevent the formation of hernias in osteochondrosis of the spine and other complications. It is prescribed after diagnostic examination of the patient. Otherwise, the disease will continue to develop, which can lead to the development of dementia.
Consult a neurologist for back pain. He will listen to complaints, investigate and feel the back, ask about existing diseases. In addition, your doctor may prescribe the following:
- Radiography. Spinal radiography will help assess the condition of the intervertebral discs and spinal cord. In the absence of visible changes, grade 1 lumbar osteochondrosis is diagnosed.
- Computed tomography (CT). If the X-ray shows changes in the lumbar spine, it is determined. It can be used to assess the degree of damage to the discs, nerve endings and spinal cord.
- Magnetic resonance imaging (MRI). It is an alternative to CT, which can be prescribed if there are contraindications to X-ray examination. Suitable for pregnant and lactating women
Sometimes computed tomography and magnetic resonance imaging with intravenous contrast are performed. This is the name of the substance that illuminates the tissues from the inside. With its help you can get the highest quality images of the spine. Contrast-enhanced CT and MRIbel are performed to rule out tumors that are not characteristic of osteochondrosis, and in this case, treatment is delayed until the final diagnosis.
Treatment of lumbar osteochondrosis and its types
The doctor prescribes treatment taking into account the stage of development of the pathology. Formulated to relieve pain, stop inflammatory processes, restore metabolism and blood circulation in the affected area. Treatment of lumbar osteochondrosis also includes a number of measures aimed at strengthening the legs and hips.
Most treatments are conservative. These include drug treatment, physiotherapy and exercise therapy, folk remedies. Treatment of lumbosacral osteochondrosis in grade 3 does not always lead to the desired result with conservative methods. In this case, the patient's condition may facilitate surgery.
Drug treatment is effective in the 1st and 2nd stages of pathology development. However, it is important to remember that the choice of medication is determined by the symptoms of osteochondrosis of the spine, and medical treatment is strictly prescribed by a doctor. Just do not go to the pharmacy and ask for a remedy for osteochondrosis. Even if it is sold to you, the treatment will not be effective.
The patient may be prescribed the following groups of drugs:
- Analgesics. They help to get rid of severe persistent pain in lumbar osteochondrosis. It can be applied topically (ointments, gels), taken orally (tablets) or injected intramuscularly with a syringe (solution).
- Non-steroidal anti-inflammatory drugs. They have a triple effect: lower the temperature, reduce pain and reduce inflammation. With lumbar osteochondrosis, low back pain or inflammation of the sciatic nerve is prescribed. Use a gel, pill, or injection topically to fight inflammation to relieve pain.
- Muscle relaxants. This is the name of the remedy for painful muscle spasms. It is taken orally in tablet form or intramuscularly in solution.
- Chondroprotectors. Provide effective drug treatment in the early stages of lumbar osteochondrosis, if you complete the full course. This group of drugs stops the destruction of intervertebral discs and restores them.
In addition, the patient is prescribed vitamins and vitamin-mineral complexes to restore intraosseous metabolism. Your doctor may also recommend dietary compliance. The goal is not only to reduce body weight, but also to enrich the body. protein, natural vitamins and minerals.
Medication for lumbar osteochondrosis is not enough. It should also cover physiotherapy methods. Reduces pain, relaxes muscles and restores local metabolism. The following procedures are often prescribed to patients:
- laser therapy (laser treatment of the spine);
- magnetic resonance therapy (exposure to a magnetic field);
- darsonvalization (effect of high-frequency pulse currents on the affected area);
- phonophoresis (injection of drug solutions into the deeper layers of the skin using ultrasound).
Manual therapy is also very effective. For lumbar osteochondrosis, back massage is prescribed after the pain has stopped. It relaxes muscles, speeds up blood circulation and therefore nourishes tissue. It is useful to combine massage with a bath or sauna. However, warm-up procedures are allowed only during the period of elimination of the disease.
Gymnastics for lumbar osteochondrosis includes exercises aimed at strengthening the muscle corset. They increase the mobility of the spine and increase blood circulation in the tissues. Stops degenerative processes and improves the patient's condition.
The main set of exercise therapy includes 5 exercises:
- Bending. Strengthens abdominal musclesLie on your back, bend your knees and cross your arms behind your head. Then inhale and exhale, lifting your body as you want your chest to touch the pubis. At the same time, the lower back should remain pressed.
- "Cat" exercise. Relaxes back muscles, relaxes spine. Stand on all fours (on your knees, palms on the floor). When the cat sees danger, raise your head and bend your back. Then slide your head and bow down, as you would when a cat wakes up.
- inclined turns. Strengthens the muscles of the abdomen and thighs. Lie on your back, cross your arms behind your head, bend your knees and squeeze each other. Before separating the legs, turn them to the right, touch the ground with them, return to the starting position and do the same with the left side. The body should remain motionless.
- Glute Bridge. Strengthens hip muscles, prevents curvature of the spine and corrects curves. Lie on the floor, put your arms along your body, bend your knees. Lift your pelvis and hold this position for 5 seconds.
- Exercise to stretch your lower back and legs. Sit on the floor with your legs outstretched in front of you, spread shoulder-width apart. First, bend one leg and pull your fingers with your hands, feeling the muscles stretch. Hold for 20-30 seconds. Now do the same with the other leg.
You should start with the minimum number of repetitions of exercises and gradually increase to the maximum (3 sets 10-20 times). They must be performed every day. It does not take more than 10-15 minutes, but prevents the recurrence of osteochondrosis.
Attention! Gymnastics is contraindicated for acute back pain.
Osteochondrosis of the spine can be treated at home with folk remedies. These are not a substitute for medication, but a good addition. Below are some of the most effective traditional medicine recipes. against back pain.Boil water in a saucepan so that strong steam comes out. Steam the burdock leaves for 10 minutes.
|tincture based on human roots||Warming, analgesic.||Pass 200 g of carrots through a fine grater, put in a bowl and pour 0. 5 liters of vodka. Put in a dark place and leave for 5 days.||Rub the scarf under your waist, put on a woolen belt or tie a warm scarf.|
|Burdock leaf compression.||Painkiller.||Boil water in a saucepan so that strong steam comes out. Steam the burdock leaves for 10 minutes.||Add the leaves to the sore spot. Cover with plastic wrap and wrap. Keep for 1-2 hours.|
|Coniferous bath||Warming, relaxing, analgesic.||Take a hot bath, put some spruce or pine branches in the water. Add 10 drops of essential oil of any coniferous tree (cedar, pine, corn, juniper).||Bathe for 10-15 minutes. Then dry and wrap yourself.|
|Herbal decoction||Vitamin, anti-inflammatory, normalizes metabolism.||Put 10 g of lingonberry leaves, hop cones, thyme and swordfish in a pot. Pour 500 ml of water, put on the stove and bring to a boil. Extinguish the fire. Cover and infuse for 1 hour. Tension.||Take 1/4 tablespoon. after eating three times a day. The course of treatment is 1 month. The maximum period is 6 months.|
|Lidocaine Ointment||Painkiller.||Melt and cool 200 grams of butter, add 75 grams of beeswax, 30 g of marshmallow root, powder. Pour 1 ampoule of lidocaine into the mixture, mix everything until smooth.||Rub into painful areas as needed. Store in a place no longer than 6-7 weeks.|
Attention! The likelihood of using alternative medicine prescriptions depends on what symptoms of osteochondrosis of the spine, and home treatment with folk remedies should be closely monitored by a physician.
Surgical treatment of lumbar osteochondrosis
Surgery is a radical method. Therefore, it is applied only when complications develop or when conservative methods do not give the desired result. Generally, by this time the disease has reached 3 or 4 stages of development.
Surgical treatment for lumbosacral osteochondrosis generally involves dissection - removal of a collapsed intervertebral disc. Less commonly, an entire vertebra that compresses the nerve fibers is removed. Instead of discs, vertebrae, artificial prostheses or fragments taken from the patient's iliac crest are inserted into the spine. It is immobilized to prevent the displacement of the vertebrae and the development of the disease. To do this, the spine is reinforced with metal plates and bolts.
The operation is performed under local anesthesia with an incision of 3-5 cm. Tissues are separated by a special device to reach the spine. It takes 1, 5 to 2 hours from the application of anesthesia to the closure of the wound.
Attention! Modern technology allows you to perform operations using an endoscope - a long and flexible tool inserted into a cut about 1 cm long.
Prevention of lumbar osteochondrosis
Preventive measures should be taken to protect the health of the musculoskeletal system. They will reduce the risk of developing osteochondrosis. And if the pathological changes in the spine have already begun, it will help prevent future developments.
- If you have a sedentary job, put a roll or special orthopedic pillow under your waist.
- Dress for the weather and avoid hypothermia on your back and waist.
- Do gymnastics, running or other light sports.
- If you feel discomfort or pain in your back, consult your doctor immediately.
- Get rid of bad habits and eat right.
- Sit with your back in hard chairs. Upholstered furniture does not support the body, so the back should take all the load.
- The ideal chair height is equal to the length of the lower leg. Then he will stand with his feet on the ground while sitting. If you are small, you can put a support under your feet.
- The ideal sitting depth is 2/3 of the length of the thigh. Less is possible, but not more.
- Legs should be wide under the desk.
- Sit with your back against the back of the chair.
- Do not bend your head or body while sitting - keep it straight.
- Use music relaxation to keep your head down while reading.
- Do a series of gymnastic exercises after long hours.
- Change your position every 10-15 minutes, leaning first on one leg and then on the other.
- If you can move on the spot, do it.
- Do a few back bends every hour, raising your arms. Take a deep breath as you bend. This exercise relaxes your back and lower back as well as your head and neck.
- If you work on your feet (ironing, cooking), put a bench under one foot. The height should be equal to the height of one step.
- Extend the vacuum hose by pulling an extra tube to prevent bending when cleaning at home. Use the mop to wipe. You can clean the floors while crawling on your knees, but without bending over.
- Lie on a hard orthopedic mattress.
- Instead of a mattress, a thick solid board (plywood) covered with foam rubber up to 8 cm thick is suitable, put a woolen blanket and a sheet on top.
- If your legs hurt, put a towel wrapped under your knee.
- If you like to sleep on your stomach, use a thin pillow under it.
- If you like to sleep on your side, put one foot on the other and your hands under your head.
- Distribute the load evenly on both arms. Frequent transportation of weights in the same hand causes curvature of the spine.
- If you have previously been diagnosed with osteochondrosis, do not carry items weighing more than 15 kg. It is better to use a bag or a cart with wheels to move them.
- If you need to lift or carry a heavy object, first bend down with your back straight. Then take the weight in your hands, stand up and press it on your stomach. You also have to sit and squat to lower a heavy object.
- Eat 3-4 times a day.
- Enrich your diet with protein: fish, lean meat, legumes, cottage cheese.
- Limit your intake of sweets, pastries and fatty foods.
- Include more vegetables and fruits in your diet.
- Eat foods rich in calcium and phosphorus (cheese, dairy products, fish).
- Don't overeat - excess calories accumulate like fat and cause excess weight.