Lumbar osteochondrosis: causes, symptoms, diagnosis, treatment

Lumbar osteochondrosis is a dangerous disease of the spine, characteristic of people over 35 years old. The natural wear and tear of the joints causes the development of pathology. Untimely access to a rheumatologist in most cases leads to disability. Modern medicine offers many effective methods of treatment in the primary stage. Early diagnosis is the key to a healthy life without restrictions.

Lumbar osteochondrosis - general definition

Osteochondrosis of the lumbar spine is a dystrophic degenerative process in the intervertebral cartilaginous formations - intervertebral discs.

The intervertebral discs perform the main functions of the spine - the ability to move and bend, resistance to stress. As a result of the pathology, important elements become thinner, deformed, the vertebrae are aligned, nerve endings and blood vessels are pinched. Negative processes are accompanied by pain sensations of varying intensity and limitations in motor skills.

The pathology causes changes in the connecting elements of the spine - cartilage, bones, intervertebral discs and joints. It is caused both by natural wear and tear processes and by acquired joint diseases or as a result of a wrong lifestyle.

causes

The development of lumbar osteochondrosis can have many causes:

• Natural or premature wear and tear of the body;
• Excessive strain on the lower back - lifting loads, working "on your feet" or a sedentary, "sedentary" lifestyle;
• Genetic predisposition to joint diseases such as rheumatoid arthritis;
• violation of metabolism, which leads to the accumulation of toxic substances in the connecting disks;
• Chronic diseases of the circulatory system. Nutrients and trace elements no longer reach the cartilage tissue in sufficient quantities. Hypoxia sets in, which contributes to the destruction of the intervertebral joints;
• autoimmune pathologies.

Secondary factors can also provoke the development of lumbar osteochondrosis:

• Chronic injuries, back contusions;
• Exceeding the weight norm by more than 15-20%;
• heavy or weight training;
• Constantly wearing uncomfortable shoes. High heels, tight shoes, rubber or sports shoes are the first enemies of the spine;
• valgus changes in the foot;
• scoliosis, kyphosis, diabetes mellitus, spinal tuberculosis;
• Influence of low temperatures.

clinical picture

The symptoms of lumbar osteochondrosis depend entirely on which nerve roots are affected by the disease. The degree of compression of the vertebrae, the stage of the disease and damage to the intervertebral disc determine the signs.

Rheumatologists distinguish the following main symptoms:

• Violation of tactile sensitivity in the lumbar region. The numbness extends to the inner thighs and groin. May affect one or both limbs;
• There is a sharp, stabbing pain in the lower back. The big toe completely loses mobility and a characteristic numbness is observed;
• Loss of normal function of the foot, tenderness of the fingers, lower leg and outer thigh. In these parts of the leg there is tone and regular seizures. On examination there is no Achilles reflex;
• When the disease affects the inferior root artery, there is complete paralysis of the muscles of the buttocks, hamstrings and perineum. There is a severe violation of motor function, up to complete immobility.

With lumbar osteochondrosis, not only the nerve endings of the spine are affected, but also the blood vessels.

The following specific signs depend on the type of lesion:

• If only the nerve roots are disturbed, a change in the patient's gait is observed. Pain is localized not only in the lumbar region, but also in all parts of the legs. Radicular syndrome is characterized by constant pain. Usually only on one side. Tingling and pain are noted in the lower back. Pain can be relieved with a little exercise.
• The compression of the blood vessels leads to blood flow in the hip area. As a result, there is a lack of oxygen in the intervertebral discs. When walking, painful sensations appear in the buttocks, thighs and lower back. Completely removed after a night's rest.

A simultaneous violation of the functionality of blood vessels and nerve roots can lead to irreversible deformation of the intervertebral discs. Spiny bony outgrowths form in the movable joints of the lower back. This causes severe pain and makes normal natural movement impossible. Injured posture, gait. Complete paralysis can occur as the disease progresses.

stages of the disease

Lumbar osteochondrosis develops gradually in several stages. Each stage has its own characteristics that determine the level of progress.

• I direct.The slow destruction of the intervertebral discs begins. The process can last from several months to 2-5 years. Manifested by mild pain, discomfort in the groin and thigh muscles. It is noticed when walking or when the weather changes.
• Stage IIThe collagen fibers of the fibrous rings of the spine are drawn into the negative process. The distance between the individual vertebrae is rapidly shrinking. Friction occurs, which causes severe attacks of pain. Injured gait, posture, bending over appears. Lumbar osteochondrosis is most often diagnosed at the second stage of the course.
• III. Stage.An intervertebral fracture occurs. And if the patient was not compelled to seek medical attention with the stage II symptoms, then ignoring the excruciating stage third pain will no longer be possible. The deformation of the bones and joints of the spine in the lumbar region is already irreversible. Walking takes a lot of strength. This is due to the pain and the inability to relieve it with traditional painkillers.
• IV stage.Partial or complete impairment of motor function. At this stage, the patient is assigned to a disability group. Threaten with complete paralysis. Without taking a variety of medications, vital activity is impossible.

diagnostic measures

Diagnostic measures involve several techniques and begin with the collection of a complete medical history. During the first consultation with a rheumatologist, the following data will be clarified:

1. The patient's complaints are carefully analyzed - the place of pain localization, where discomfort is still felt, in which parts of the hip joint there is a feeling of heaviness, cramps, etc. ;
2. duration, regularity, type of pain;
3. When the first, even minor, symptoms appeared. How much time has passed since the last attack, what causes discomfort and what factors contribute to its elimination?
4. Surrounding living conditions of the patient. Profession, work, household load, sports and the presence of additional factors for increased physical activity (dacha, garden, hobbies related to the transfer of weights);
5. Examination of the history of diseases from which the patient has suffered in the past or present.

After assessing the clinical picture, the rheumatologist proceeds directly to the external examination. During the examination, the gait, the anatomical position of the legs, arms and trunk in relation to the spine are analyzed. The skin is examined for changes - pigmentation, peeling, eczema, rashes, etc. An assessment of motor skills is given.

By performing simple exercises - tilting forward and backward, raising arms and legs, turning the head, twisting movements of the pelvis - the patient allows the doctor to determine the degree of damage to the spine in the lumbar region.

The final measures of the external examination are measures to determine the degree of radical damage:

• Symptom Lasege.Lying on his back, the patient alternately raises his legs, bent at the knee. If this causes pain in the lower back, the readings are considered positive.
• Symptom Dejerine.The patient is asked to contract the abdominal muscles as much as possible. The appearance of discomfort in the spine indicates the development of lumbar osteochondrosis.
• Symptom Neri. Severe tilting of the head forwards and backwards reacts with pain in the lower back.
• Symptom Aquarius. In the supine position, the patient moves the leg to the side as far as possible. In the presence of a pathology, there are unpleasant pains in the groin and in the front of the thigh.

To confirm or exclude the diagnosis, the patient is invited to an instrumental diagnosis. MRI is considered the most effective method for determining lumbar osteochondrosis. The study shows the distance between the vertebrae, the development of neoplasms and bone deformities. It may be contraindicated in patients with mental disorders.
Computed tomography gives a fairly true picture of the disease in one plane - horizontal or vertical.
X-ray is used only in the last stages, when irreversible changes in the bone tissue of the spine begin.

Complex treatment of lumbar osteochondrosis

The causes of the pathology are not fully understood. Scientific research in the field of joint diseases of the spine has not yet identified sufficiently effective methods for the complete restoration of intervertebral discs. Modern methods of treatment are aimed only at eliminating the external signs of the disease. A full recovery is currently considered impossible.

Traditional drug therapy

Depending on the general condition of the patient, the rheumatologist will prescribe medication. The clinical picture provides the necessary information for the creation of a treatment scheme with drugs from several groups.

1. anesthetics.Injections, ointments, or broad-spectrum drugs are prescribed.
2. Anti-inflammatory drugs (NSAIDs).
3. vasodilators.Removal of tone from the muscles of the lumbar and leg muscles.
4. chondroprotectors.Designed to exclude the negative course of lumbar osteochondrosis.

physical therapy

Physiotherapeutic procedures are an integral part of inpatient or outpatient treatment of lumbar osteochondrosis.

Includes the following activities:

• electrophoresis with painkillers;
• magnetotherapy;
• hydrotherapy;
• paraffin applications.

Medication and physiotherapy in the complex relieve acute pain and inflammation. But they are not a guarantee of stopping the progress of pathology. Just one course 2-3 times a year and a responsible attitude of the patient will help to avoid regression and maintain the general condition in a satisfactory form.

Exercise therapy and therapeutic massage

A set of exercises of therapeutic gymnastics will ensure the normalization of blood circulation in the lower back and help get rid of stagnant processes. Only a physical therapist can prescribe exercises for clinical or home use. Usually these are all sorts of gentle inclines and rotations, from the prone and seated positions. Independent physical activity can not only not bring any result, but cause even more displacement of the intervertebral discs.

Manual therapy sessions help strengthen muscle tissue, increase blood flow to the affected lower back, and release tension. The specialist first massages a healthy part of the back to warm up the muscles and improve blood circulation. Then it goes to the affected areas of the lumbar spine. The area of manipulation includes the lower back, buttocks, thighs, shins and feet. Sessions take place in regular courses, minimum 10 sessions in 6 months.

Surgical intervention

It is indicated in the last stage of lumbar osteochondrosis to restore motor function of the spine. Surgery remains the only option for patients with the following symptoms:

• Constant pain syndrome that cannot be treated even with drugs containing opiates;
• Severe compression of the nerve roots and significant displacement of the intervertebral discs;
• neoplasms, proliferation of bone tissue;
• Complete destruction of vertebrae from constant friction;
• Paralysis.

Modern methods offer less traumatic methods of internal intervention. For example endoscopy. It has a favorable prognosis, a short rehabilitation period and a low rate of side effects.

alternative treatment

Lumbar osteochondrosis responds well to treatment with medicinal herbs and folk methods. Ointments, tinctures, fee-based baths are used to relieve swelling and pain. The most effective recipes include anesthetic and anti-inflammatory herbs:

• Yarrow;
• Aloe;
• Peppermint;
• Johannis herbs;
• spruce or pine needles;
• Sage.

The content of these herbs in folk recipes is due to their medicinal effects, which have been scientifically proven by traditional medicine. Treatment at home will help keep the lower back in a stable condition and prevent the disease from worsening after complex treatment.

prevention

Despite the fact that lumbar osteochondrosis is an incurable disease, its negative manifestations can be minimized. In the early stages, the disease is successfully treated, it is only necessary to seek medical help in a timely manner. It is important to fully comply with the established treatment regimen and follow the recommendations of the rheumatologist.