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What is lumbar osteochondrosis

pain with lumbar osteochondrosis

Osteochondrosis in the lumbar region occurs due to the deformation and destruction of the cartilage tissue of the intervertebral discs.Without cartilage material, the vertebrae lose their elasticity and become displaced, causing pain.According to the WHO, the disease mainly affects people over 30 years old.Women get sick three times more often, which is also associated with age-related changes and a decrease in the level of calcium in the body.

Osteochondrosis of the lower back

Of all diseases of the peripheral nervous system, osteochondrosis of the spine accounts for 80%, of which 60-80% affects the lumbar region, consisting of 5 vertebrae.In 40% of people, the first signs of the disease appear at the age of 30-35 years.In old age, spinal osteochondrosis is diagnosed in 90% of people.Painful sensations are experienced by 7 out of 10 people, the irritation can last from 6 to 16 months.

Stages of development

  • 1 - the beginning of degenerative disorders, affecting the nerve endings and disrupting the blood supply.The inflammatory process causes pain that radiates down the leg.The patient experiences tingling sensations in the back and buttocks.Appears after heavy physical exercises.
  • 2 - the outer sheath of the intervertebral disc (fibrous ring) is destroyed.The distance between the vertebrae decreases, the nerve endings are compressed, which provokes severe, acute pain.Symptoms are especially pronounced while walking.
  • 3 - due to excessive mobility of the vertebrae, muscle fibers and nerve endings are compressed.Spasms, numbness, burning pain, herniation - displacement of the intervertebral disc in the spinal cord occur.
  • 4 - the growth of pathological exostoses in the bone structure.The spine literally "turns to stone."Progressive arthrosis and lack of treatment immobilizes the patient.

Reasons for development

The disease develops slowly, under the combination of a number of circumstances, that is, the development of the disease depends on the influence of not one, but several factors:

  • Sedentary lifestyle (physical inactivity), sedentary work, low level of physical activity.At first glance, they are not dangerous.However, with prolonged exposure, muscle tone, the so-called "muscular corset", weakens.It supports the spine and internal organs.Thus, physical inactivity provokes interruptions in the functioning of a number of systems - blood circulation, breathing, digestion.
  • Overweight.With a BMI (Quetelet body mass index) above 25 kg/m2, excess weight creates additional stress on the body: it puts pressure on the spine, overloads the joints and damages the blood supply.
  • Endocrine pathological processes.Hormonal imbalance, disturbances in the functioning of the adrenal glands and the thyroid gland "slow down" the body's metabolism.Frequent hormonal changes "wash" calcium from bone tissue, making it weak and brittle.
  • Unbalanced diet.Popular and affordable fast food fully meets the body's energy needs, while from the point of view of saturating the body with the necessary vitamins and microelements, it is absolutely useless.
  • Pathologies and genetic predisposition to diseases of the musculoskeletal system.
  • Age-related degenerative changes.Under the influence of time, the natural wear and tear of the support system occurs.

In men, whose profession involves significant physical activity, lumbar osteochondrosis occurs many times more often.

Symptoms of lumbar osteochondrosis

Pain is the main marker of the onset of the disease and its localization.Based on the nature of the occurrence, frequency and duration, a preliminary diagnosis can be made.Most often, patients with lumbar osteochondrosis experience excruciating pain that radiates to the legs, hip area, and tailbone.In a horizontal position, the discomfort disappears.

Spinal nerves extend from the trunk of the spine to various parts of the body.Each nerve is responsible for a certain area.This is called "segmental innervation".It is for this reason that the affected nerve "responds" in a specific area: this is how "radicular syndrome" appears.

The spinal nerve map allows you to identify pain with a specific area of the spine: C1-C8 - 8 cervical, T1-T12 - 12 thoracic, L1-L5 - 5 lumbar, S1-S5 - 5 sacral, C0 - 2 coccygeal.Signs of osteochondrosis depending on segmental innervation:

  • L3-L4 – weak knee reflex, partial numbness, episodic loss of sensation observed along the anterior surface of the thigh;
  • L4-L5 – Muscle weakness, the patient is unable to adjust the body while standing on the heels, pain and discomfort of sensitivity extend to the area from the lower back to the buttocks, as well as along the entire lateral surface of the thigh (from top to bottom).
  • L5–S1 – tremors in the calf muscle, inability to stand on tiptoes, pain in the back of the thigh.

In rare cases, the radicular arteries are also involved in the destructive process, provoking a stroke in the spine - a dangerous pathology in which the patient experiences paresis and paralysis, as well as dysfunction of the pelvic organs.

Pain reflex symptoms

  • Lumbago or lumbago (in this case not sciatica!) - acute pain.Any awkward movement, even sneezing and coughing, provokes a spasm.The patient spontaneously changes the position of his body, moving it to the side.An attempt to take a vertical position provokes a new lumbago.
  • Lumbodynia is a dull, aching pain that occurs on one side.Periods of remission are followed by exacerbations, which gradually develop into severe pain.
  • Lumboischialgia - painful sensations appear in the legs.

Side signs of the disease are not so typical and can be easily confused as symptoms of another problem: impaired sweating (hypohidrosis), paleness of the skin of the affected area due to poor blood circulation, severe dryness and flaking.

Diagnosing

At the initial stage, a complete medical history of the patient is taken.The general picture should be supplemented by the opinions of the surgeon, orthopedist, neurologist and rheumatologist.Specialists subject the patient to a visual examination to assess changes in posture, muscle tone and skin sensitivity.

X-rays are performed for the primary diagnosis of grade 1 lumbar osteochondrosis;it is used to examine the condition of the intervertebral discs, pathologies of the spinal cord, as well as to evaluate the general condition of the spine.However, this type of diagnosis does not provide complete information about the affected tissues.

Computed tomography (CT) is a highly sensitive examination using a beam of ionizing rays.The CT scan records the degree of disc deformation, inflammatory processes in the membrane of the spinal cord and nerve endings in a layer-by-layer image.

Magnetic resonance imaging (MRI) shows informatively the general condition of the muscle mass, blood vessels and ligaments.Detects tumors and inflammatory processes.

Myelography is one of the ways to visually assess the condition of the spinal cord and nerve roots by injecting a contrast agent using a needle into the cavity between the pia mater and the arachnoid of the spinal cord, filled with cerebrospinal fluid.Similar to CT, MTP and X-ray, the procedure is performed in real time.

Neurological examination of sensitivity and reflexes for pathologies is a complex of studies that includes a screening method for studying limb symmetry, testing sensitivity to vibrations and evaluating Babinsky, Chaddock and Oppenheimer reflexes.

Treatment of lumbar osteochondrosis

The effectiveness of conservative treatment is achieved through a combination of drugs of different groups, massage and manual therapy.However, in stage 3, lumbar osteochondrosis can no longer be cured using conservative methods;surgical intervention is required.One of the surgical methods for osteochondrosis is microdiscectomy.This is a neurosurgical operation to remove a hernia without damaging the nerve structures.It is performed under general anesthesia.The patient can walk already on the third day.

Drug therapy (for stages 1-2)

  • Analgesics for pain relief: local (ointment, gel), oral (tablets, suspensions), intramuscular (injection solutions).
  • Non-steroidal anti-inflammatory drugs to prevent the development of the inflammatory process.Reduces temperature, removes swelling.Gels and tablets are most often used, in more severe cases (inflammation of the sciatic nerve) - injections.Premium course - 7-14 days.
  • Muscle relaxants.It is prescribed in the acute period for muscle spasms, as well as during the remission period to consolidate the effect.
  • Chondroprotectors.They block destructive processes in intervertebral discs, promote regeneration, improve metabolism in cartilage tissue.
  • Vascular drugs.It helps to normalize blood supply to the musculoskeletal system.
  • Complexes of group B vitamins. Improve nerve conduction.
  • Diuretics.Reduces swelling.

As emergency help at the time of irritation, powerful injections are used - paravertebral blockade, which causes a temporary loss of sensitivity.

It is also recommended to undergo a course of manual therapy twice a year, which relieves tension and muscle spasms, restores blood circulation, improves lymphatic circulation and increases the mobility of the musculoskeletal system.

Preventing

  • An active lifestyle combined with moderate physical activity;
  • Choosing comfortable or, if indicated, orthopedic shoes;
  • Good food;
  • Body weight control;
  • Sleep only on an orthopedic mattress and pillow;
  • Office furniture with flat backs only;
  • Rejection of heavy loads on the back and back.When carrying heavy objects, the load should be distributed equally in both hands.