According to medical statistics, low back pain in 80% of cases is caused by lumbar osteochondrosis. This occurs as a result of degenerative-dystrophic changes in this segment, when the intervertebral discs and adjacent vertebrae are affected. Osteochondrosis of the lumbar spine (OBOP) manifests itself in a variety of symptoms: pain of a different nature, limitation of mobility, decreased sensitivity of the lower body, etc.
To avoid dangerous complications of lumbar osteochondrosis (LP), you need to start complex treatment at 1-2 stages of the pathology. In advanced cases, when irreversible changes to the disc or vertebrae are already present, an operation is performed. To avoid osteochondrosis of the lower back and associated complications, it is necessary to carry out its prevention.
Development of lumbar osteochondrosis
To understand what osteochondrosis of the lumbar spine (lumbar spine) is, you need to study the structure of the spine. It consists of vertebrae, between which are placed cartilaginous pads (intervertebral disc). The disc is covered with a hard fibrous membrane (annulus fibrosus), inside of which is the nucleus pulposus. This structure has a shock absorbing function and makes the spine more flexible.
. The lumbar segment of the spine is under tremendous stress on a daily basis, as it can support the weight of the upper body. Therefore, osteochondrosis of the lower spine is diagnosed more often than cervical and thoracic.
With regular stress on the spine, the discs contract, lose a lot of fluid, their height decreases, and the distance between the vertebrae decreases. The cartilage lining becomes brittle, microcracks appear on its surface, through which the nucleus pulposus protrudes over time. With further compression of the intervertebral discs, the outer shell ruptures and the gelatinous body falls, forming a hernia. Then there is a pathological mobility of the vertebrae, the load on the adjacent segments of the spine increases.
A little later, bony growths (osteophytes) begin to form on the edges of the vertebral bodies. Thus, the body tries to stabilize the spine.
Doctors distinguish 4 stages of osteochondrosis of the lumbar spine:
- 1 degree - problems with the discs begin, the central part becomes dehydrated, it flattens, cracks appear on the outer shell. Has an erased current.
- Grade 2 - the cartilage lining sags, the vertebrae move closer to each other, become more mobile, the muscles and ligaments around the spine sag. The pain appears.
- 3 degrees - protrusions, hernias and subluxations of the vertebrae are formed. Pain increases, mobility is limited, the sensitivity of the lower body is disturbed.
- Grade 4 osteochondrosis is characterized by the appearance of osteophytes which can damage the spinal nerves and adjacent vertebrae. There is constant pain, severe neurological disorders and other complications, and the risk of disability increases.
The easiest way to cure lower back chondrosis (stage 1), but identifying the disease at this stage is very difficult. 2nd degree intervertebral osteochondrosis is treated by conservative techniques. Surgery may be needed in stages 3-4.
. According to statistics, OBO is more often detected in patients after 30 years. There are frequent cases of the development of pathology in people after 20 years. About 80% of 60-year-old patients suffer from manifestations of this disease.
To understand how to treat PKOP osteochondrosis (lumbosacral spine), you need to know its causes:
- Regular static or dynamic load on the lumbar segment. The risk group for the development of osteochondrosis includes office workers, professional athletes (weightlifting), movers, builders, etc.
- Poor posture, prolonged inappropriate posture.
- Genetic predisposition, abnormalities in the formation of vertebral bodies. This category includes young software - curvature of the spine, caused by pathologies of the vertebral bodies.
- Injury to the spine.
- Hormonal imbalance, metabolic disorders, diseases of the endocrine glands, which disrupt the metabolism in the lumbar segment.
- Age-related changes in the body cause disc wear.
- Tuberculosis of bone, osteomyelitis (purulent inflammation of bone tissue), ankylosing spondylitis (inflammation of the vertebrae and joints), rheumatoid arthritis, etc.
Illness is often caused by more than one cause.
In addition, there are factors that provoke the development of lumbar osteochondrosis:
- Passive lifestyle, prolonged sitting.
- Regular consumption of unhealthy foods (fatty foods, fried foods, confectionery, semi-finished products, etc. ).
- Lack of fluid, dehydration.
- Congenital disorders of the structure of the spine, for example an additional vertebra.
- Wear uncomfortable heels regularly.
- The gestation period, then the load on the spine increases.
- Abrupt refusal to train professional athletes or excessive sports by people who previously led a passive life.
- Smoking, frequent and excessive alcohol consumption.
Many other factors can trigger degenerative-dystrophic processes in the lumbar spine. For example, flat feet, frequent hypothermia of the back, frequent stress, sleep disturbances, etc.
The symptoms of osteochondrosis of the lumbar spine are diverse, they depend on the stage of the pathology and the location of the affected area.
Doctors distinguish between reflex and compression syndromes (symptom complex) in OBOR. The former occur when receptors on the outer membrane of discs, ligaments and joint capsules are irritated, and the latter occur when nerve bundles, blood vessels and the spinal cord are compressed.
There are such reflex syndromes of lumbar osteochondrosis:
- Lumbago. Shot of pain in the lower back with sudden movement or effort. At the slightest attempt at movement, the pain syndrome intensifies, so that the patient freezes in one position. The muscles in the damaged area are very tight, on palpation the painful sensations become more pronounced. These manifestations are associated with the movement of the nucleus pulposus within the outer shell.
- Lumbodynia. The aching pain develops over several hours or days. Discomfort increases with movement, the change in body position. It is weakened when a person assumes a horizontal posture with a roll under the lower back. When lifting a right leg in this position, the pain increases (Lassegh symptom). The degree of muscle tension is less than that of lumbago. Mobility of the lower back is limited.
- Lumboischialgia. Painful sensations (sharp or painful) spread from the lower back to the lower body. There is an increase in this sign during movements. The pain is relieved by resting on the back. The muscles in the affected area are tense, the pain syndrome becomes pronounced on palpation.
Symptoms of compression syndromes depend on which parts of the lumbar segment are damaged. The characteristic signs are associated with compression of the spinal nerves by hernias, osteophytes, displaced vertebrae. This condition is called radiculopathy, in which the pain increases with the slightest movement, the muscles in the lower back are tense, and mobility is limited.
Clinical manifestations of compression syndromes depending on the damaged vertebrae of the lumbar segment:
- L1 - L3 - pain and numbness in lumbar region, front and inner thigh, patient has difficulty bending / unfolding leg at knee level.
- L4 - pain syndrome extends to the front of the thigh, goes down to the knee (behind). In the same area, the sensitivity is disturbed.
- L5 - painful sensations radiate to the buttocks, the outside of the thigh, down along the front of the leg to the inside of the foot and the big toe. In the same area, numbness is felt, it is difficult for the patient to bend the big toe.
- S1 - the pain spreads from the lower back to the buttock, the outside and the back of the thigh, descends to the outer part of the lower leg, the foot. In the same areas, numbness is felt, the muscles of the leg are weakened, so it is difficult for the patient to stand on his toes.
There is a risk of damage to several nerve bundles at the same time, eg L5, S1. If the hernia recedes, it can compress the spinal cord.
Compression of the blood vessels in the lower back increases the risk of weakened muscles in the legs, numbness in the lower limbs, disturbances in controlling the process of urination and defecation. In men with OBO, erections are impaired, and in women, the main symptoms may be supplemented by inflammation of the ovaries or uterus.
To diagnose OBO, the doctor examines the patient, palpates the patient to determine the condition of the muscles and identify the curvature of the spine. It is important to inform the specialist in detail about your symptoms in order to facilitate the diagnosis.
Instrumental exams will help detect intervertebral osteochondrosis:
- X-ray of the lower back (front and side projection).
- Magnetic and computed resonance imaging.
The x-ray allows you to assess the structure of the PPE. To identify abnormal mobility of the vertebrae, x-rays are taken in flexion and extension position. This study found that the intervertebral fissure narrowed, the vertebral bodies shifted, and osteophytes appeared on their edges. However, this diagnostic method is considered obsolete.
Today, computed tomography and MRI scans are increasingly used to detect degenerative-dystrophic changes in the spine. These very informative studies allow us to assess the condition of the vertebrae, discs, intervertebral foramen and spinal cord. With their help, the protrusions, the direction of the hernia, the degree of compression of the nerve bundles, spinal cord and blood vessels are detected.
MEDICINES FOR LUMBAR OSTEOCHONDROSIS
Treatment for EPP osteochondrosis lasts from 1 to 3 months to 1 year. The success of therapy depends on the patient himself, who must strictly follow the recommendations of the doctor. With self-medication, the patient's condition usually worsens.
Objectives of the treatment:
- Stop or alleviate software symptoms.
- Identify the cause of the disease, try to exclude it from life.
- Eliminate the inflammatory process.
- Restore blood circulation, metabolic processes in the lumbar spine.
- Try to improve the condition of the damaged cartilage lining, to stop further degenerative changes.
To achieve such goals, it is recommended to perform complex therapy. It usually starts with taking medication:
- Muscle relaxants. They relax muscles, relieve pain and inflammation.
- NSAIDs. They have anti-inflammatory, analgesic, antipyretic effects.
- Antispasmodics. They help to stop smooth muscle spasms, relieve pain.
- Anesthetics. They are used for severe pain syndrome in the form of therapeutic blockade.
- Glucocorticosteroids. They also help to cope with pain. However, these drugs are capable of destroying bones, so they are taken for a short time and only after doctor's approval.
- Sedatives. They relieve neuromuscular tension, improve sleep.
- Vitamins (group B, E, C, A). Restores the condition of the affected nerves, relieves pain.
Warning. It is forbidden to take NSAIDs with gastritis or stomach ulcers, as they further damage the mucous membranes of the gastrointestinal tract.
In case of exacerbation, the patient is given injections, and after relief of the main symptoms, he takes oral medications.
In addition, external agents are used (gels, ointments, creams, rubs).
The question of what to do with chronic lumbar osteochondrosis is very relevant. If OBOP has become chronic, after relief of the main symptoms, the patient is prescribed chondroprotectors, drugs that restore blood circulation, drugs based on B vitamins. They help restore innervation, normalize lblood supply to the affected area and prevent further development of the pathology.
Treatment of chondrosis of the lumbar spine (stage 1) is carried out with the use of chondroprotectors, which slow down the development of degenerative processes, accelerate the regeneration of cartilage. In addition, the patient is prescribed vitamin and mineral complexes. This form of osteochondrosis is the easiest to cure.
OTHER CONSERVATION TECHNIQUES
In case of acute chronic disease (osteochondrosis) of 1-2 degrees, the following treatment procedures will help to stop its development:
- Ultrasound therapy relieves pain and inflammation and normalizes blood flow to the damaged area.
- Detensor therapy is a safe traction of the spine due to the weight of one's own body, after which muscle tone normalizes and mobility improves.
- Magnetotherapy reduces pain and inflammation in the muscles around the spine.
- Reflexology (inserting needles into bioactive points of the body) speeds up blood circulation, relieves inflammation and edema.
- Manual therapy (impact on the affected area with a doctor's hands) and massage normalize muscle tone, reduce compression of nerve bundles, improve the nutrition of the intervertebral discs and restore the structure of the spine. Electrophoresis
- allows the delivery of medicinal solutions through the skin to bone and cartilage tissue.
- Drasonalization improves blood circulation, metabolic processes, reduces pain, restores skin sensitivity.
There are many more effective procedures that will help improve the patient's condition within 5 to 15 sessions. The main thing is to get a doctor's approval before performing them.
PROCESSING WITH HOME SOFTWARE
If you are wondering whether it is possible to treat OBO at home, consult your doctor. If the specialist has given permission, start therapy, which usually includes the following:
- Diet. If lumbar osteochondrosis is caused by impaired blood circulation or metabolism, exclude fatty, fried, spicy foods, eggs, etc. Give up alcohol, tonic drinks (tea, coffee). Drink filtered water, compotes, herbal teas.
- To restore blood circulation, exercise or apply rubs and compresses.
- Sleep on an orthopedic mattress, a low pillow. If you have a sedentary job, buy a chair with a backrest that will support your spine. Occasionally wear special corsets or belts.
- Exercise therapy will help strengthen the muscle corset, relieve some of the load on the diseased spine. The complex for each patient is compiled individually by a doctor or instructor.
- Self-massage of the lumbar region. However, ask a professional how to do it correctly.
- Use folk remedies in the form of rubs, compresses, baths, etc.
- A needle applicator is a plastic plate with many tips that improves blood circulation, metabolic processes in the damaged area, reduces muscle pain, and relaxes.
And also at home you can use lotions with herbal decoctions, plasters.
. A novelty in the treatment of osteochondrosis is a massage bed, which is suitable even for the most disorganized patients.
However, remember that home treatment can only be done with the permission of your doctor.
Operation for lumbar osteochondrosis is prescribed if conservative techniques have been shown to be ineffective for a long time. Surgery is also indicated for involuntary urination, defecation, and cauda equina syndrome (pinching of the nerves in the lower spinal cord).
The following surgical methods are used in the treatment of OBO:
- Spondylodesis - fusion of adjacent vertebrae.
- Facetextomy - removal of the intervertebral joints that pinch the spinal nerve.
- Laminectomy is the removal of the blade that covers the spinal canal that compresses the spinal cord.
- A discectomy is the complete or partial removal of an intervertebral disc that causes compression of the nerve root or spinal cord.
- Corpectomy - removal of the vertebral body and adjacent cartilaginous pads. Then the empty space is filled with a bone graft and 3 vertebral segments are fused.
. After surgery, there is a risk of complications: spinal cord injuries, nerve bundles, broken grafts, infections, etc.
After treatment, you should undergo rehabilitation to speed up your recovery.
In the absence of proper treatment, the risk of such complications of lumbar osteochondrosis increases:
- Herniated disc, pinched nerve root, or spinal cord.
- Prolonged inflammation increases the risk of developing radiculitis (inflammation of the nerve roots).
- Sciatica (inflammation of the sciatic nerve), in which there is severe pain and numbness in the lower extremity.
- If the blood circulation in the spinal cord is impaired, the risk of compression myelopathy (compression of the spinal cord by various formations: bone fragments, hernia, tumors, hematoma) increases.
- Cauda equina syndrome - compression of the roots of the lower spinal cord, resulting in disruption of the functionality of the intestines, pelvic organs and lower limbs.
To avoid such complications, you should start treatment as soon as possible.
To avoid lumbar osteochondrosis, follow these rules:
- Lead a moderately active lifestyle (walk more often, exercise regularly, join a swimming pool).
- For sedentary work, warm up every 1. 5 hours.
- Sleep on an orthopedic mattress.
- Avoid excessive physical exertion, lift weights only from a semi-squatting position, before that put on a special belt in the lower back.
- Buy orthopedic shoes.
- Eat well, take vitamin and mineral complexes as prescribed by your doctor.
- Learn to relax.
- Try not to become hypothermic.
- Treat diseases that can cause OBO in time.
- Give up bad habits.
By following these recommendations, you can prevent degenerative changes in the spine and improve your health.
If you notice any symptoms of lumbar osteochondrosis, seek urgent medical attention. Self-treatment can make your condition worse and lead to complications. Lumbar chondrosis (stage 1) is treated with exercise therapy, physiotherapy, and chondroprotectors. In later stages, drugs, massage, manual therapy, etc. are used. In the absence of positive dynamics for a long time or in the event of the appearance of neurological symptoms, the doctor may prescribe an operation. The patient should strictly follow the doctor's recommendations in order to speed up healing.