In the medical literature, the term "spinal osteochondrosis" refers to degenerative processes in the ossification center of children. The disease common in medicine, considered the most common of all musculoskeletal problems, is hidden behind the words sciatica, disc herniation, dorsalgia (back pain). The lower back, according to official statistics, suffers more often than the other parts, leading to serious complications for the whole body. Why does this happen and how to treat osteochondrosis?
What is lumbar spine osteochondrosis
Degenerative neuro-orthopedic disease affecting the intervertebral discs, leading to secondary compensatory and reactive changes in the osteo-ligamentous device and nervous system, according to osteochondrosis doctors. It mainly affects the lumbar region, which is located between the chest and sacrum and consists of five vertebrae. There are disks between them - fibro-cartilage formations consisting of the following elements:
- cartilage tissue (a membrane involved in the feeding of plates from the blood vessels of the vertebral body);
- nucleus pulposus (gelatinous mass with a nucleus pulposus in the middle);
- annulus fibrosus (protects the liquid part).
Circulatory problems, changes in the composition of cartilage tissue, dehydration of the nucleus pulposus, flexibility and resilience of the intervertebral disc, and its fixative properties suffer fromAdverse factors weaken muscle fixation and give the vertebrae excessive mobility. Degenerative and destructive processes then affect the bony surfaces of adjacent vertebrae, resulting in spinal dystrophy (tissue malnutrition).
The following process looks like this:
- Microcracks appear in the loose ring. The nucleus pulposus begins to penetrate it, gradually breaking through the annulus fibrosus and injuring it, leading to disc herniation or protrusion (initial stage).
- A hernia compresses the spinal canal, squeezing nerve roots and blood vessels, causing pain and motor activity.
- Due to the increased pressure on the vertebrae (starting with the thinning of the disc), accelerated production of bone tissue begins and vertebrate processes (osteophytes) develop.
Some experts tend to refer to intervertebral osteochondrosis of the lumbar spine and others as a "civilization disease, " primarily because of the vertical posture that has increased the strain on the back of modern man. The disease begins most often in people over the age of 30 and is diagnosed more often in men than in women.
Lumbar osteochondrosis can develop:
- overload of the spine (household, professional, sports);
- weak back muscles;
- incorrect distribution of household load on the spine (in the lumbar spine - the most common cause);
- frequent tension in the back muscles;
- is overweight, especially in the background of diabetes mellitus; spinal injuries;
- violation of metabolic processes;
- improperly fitted shoes, flat feet;
- posture problems that result in an uneven distribution of load along the spine; lumbar spine
- sedentary lifestyle, long-term driving;
- hormonal disorders (especially in women);
- congenital diseases of the musculoskeletal system;
- age (natural changes in the tissue of fibrocarcinoma occur in people over 50 years of age);
- common stress, emotional stress.
Degrees of development
The course of the disease is slow and gradual, with most patients only recognizing a serious problem at stage 2 or later. Without proper treatment, osteochondrosis can progress and lead to disability.
Main medical classification:
- The initial stage is characterized by the beginning of the destruction of the intervertebral discs, their flexibility, the decrease of their flexibility. The disease feels primarily with a load on the spine.
- Destructive processes affect the annulus fibrosis, the distance between the vertebrae decreases (the disc becomes thinner), depreciation suffers, protrusions appear (the intervertebral disc bulges without breaking the ring). Pinching of nerve roots and tissue inflammation occurs, which exacerbates pain syndrome.
- The annulus fibrosus ruptures and a hernia occurs. The vessels, the nerve endings, are compressed. Changes in the lumbar spine lead to general deformity of the spine.
- In the last stage, the muscles of the affected section suffer from atrophy, motor activity and ability to work. The vertebrae are noticeably curved - pronounced scoliosis (3 planar deformities), lordosis (hypertrophic forward bending of the lower back).
Symptoms of lumbar osteochondrosis
The clinical manifestations of the disease depend on the severity. The main symptom is a local pain syndrome, which manifests itself in physical exertion, heavy lifting, hypothermia of the lower back, prolonged maintenance of an uncomfortable posture (in a sitting position the load is greater than in a vertical position). Caused by irritation of the sinuvertebral (recurrent) nerve.
The stages of osteochondrosis of the lumbar spine look like this:
- In the initial stage, discomfort occurs in the lumbar region, pain is rare, especially with high background load. They pass fast.
- In stage 2, the mobility of the lumbar spine deteriorates, there is pain after and without physical exertion (with a strong cough, change in posture), it gradually increases, it lasts for a long time. Malfunctions are possible in the work of internal organs.
- With the development of osteochondrosis, the pain becomes permanent and the vertebrae deform. The nerve endings become constricted, so the pain can be given to the sacrum, the leg, it can become sharp, it can shoot. Loss of tenderness of limbs, buttocks, thighs, numbness, paraesthesia (burning, tingling, "goose hills") occur. Malfunctions of the pelvic organs appear.
- In the last stage, motor function is impaired or becomes completely impossible, curvature of the spine occurs. The pain is constant, the person unconsciously finds himself in an unnatural position to reduce it.
The reflex syndromes of the disease can be divided into 3 groups in official medicine: muscle tonic, neurodystrophic, vegetative-vascular. The last 2 categories are clearly evident in the 3 stages of the disease and later.
The clinical picture may include:
- weakened or lost reflexes of the Achilles tendon, flexion of the fingers (when osteochondrosis of the sacral region is added);
- dry skin, blue discoloration;
- urinary disorders (urinary retention or incontinence), pain in the bladder;
- cramps and pain in the thigh area against the background of eating and circulatory disorders;
- tense, insecure gait, lameness;
- increased sweating, fever with increased back pain;
- Pain syndrome radiating to the heart region (if the chest-lumbar region is affected).
If lumbar spine osteochondrosis has been diagnosed, treatment should be started immediately as the patient may be completely disabled in the final stage. Paralysis (compression) of the spinal cord by vertebrae, between which there is no space, can lead to paralysis of the lower extremities.
In addition, osteochondrosis can cause:
- disorders of the pelvic organs
- (men with erectile function, women with ovarian activity);
- lumbago (acute low back pain), sciatica (compression and inflammation of the sciatic nerve);
- intervertebral disc prolapse, stenosis (narrowing of the spinal canal);
- Damage to the lining of the spinal cord, which is fatal.
In order to make a correct diagnosis and assess the severity of the disease, the doctor collects a history of data (examination of patient complaints, lifestyle, hereditary factors). This is followed by a physiological examination, where the patient's motor skills, posture, level of sensitivity, muscle tone and size, and seizures are assessed. When knocked with a hammer, in osteochondrosis of the lumbar spine, the zones of irradiation (where it is released) are marked by pain.
After selecting a patient:
- Radiographyis the most readily available method for examining the anatomical parameters of vertebrae, assessing the tendency for narrowing of the holes between their bases, and identifying bone growth.
- MRI(magnetic resonance imaging) - helps to assess the condition of the blood vessels supplying the spine, nerve processes, plates.
- CT(computed tomography) - prescribed only to check for changes in the lining of the blood vessels, spinal cord, and to study marginal growths.
Treatment of osteochondrosis of the lumbar spine
Surgery is considered a last resort, prescribed primarily to patients with significant neurological disorders and a high risk of disability. These problems are characterized by advanced osteochondrosis of the lumbar spine - doctors try to perform stage 1 and 2 treatment in a conservative way.
The purpose of therapeutic measures is:
- elimination of pain syndrome;
- muscle cramps, removal of hypertonicity;
- elimination of the inflammatory process;
- Improving blood circulation in affected areas and metabolic processes;
- normalization of lumbar vertebral mobility;
- Restoration of lumbar sensitivity.
There is no universal method of treatment: each case of osteochondrosis requires a unique system. It is especially important to consider the form of the disease: acute or chronic. Therapy is necessarily of a combined nature, involving the use of drugs (internal and external) along with physical manipulations - massage, gymnastics, physiotherapy. The treatment regimen for osteochondrosis of the lumbar spine can be supplemented with acupuncture and hirudotherapy.
Treatment is more effective if you follow these rules:
- A special belt or corset should be worn during treatment to reduce spinal stress.
- Physical activity is excluded (only as recommended by your doctor) so that they cannot give rise to provocative factors.
- It is important to monitor your diet closely: cartilage needs sources of collagen (gelatin, aspic, jelly meat) and the whole body needs plant food, fish, nuts. It is advisable to refrain from salted, smoked, marinated products, as well as from sharp cheeses and fatty meats.
- The system prescribed by your doctor must be followed to the end: do not stop treatment when the main symptoms have disappeared, do not change your medication and procedures yourself.
- It is a good idea to choose an orthopedic mattress with your doctor that will help you relax your lower back and special shoes while sleeping. Women's heels are completely forbidden.
Acute osteochondrosis of the lumbar spine requires special attention - treatment begins with the patient being placed on bed rest for several days. Pain sensations are reduced by injections of analgesics, and novocaine blockade and glucocorticoid cannot be ruled out. Spinal traction (using a traction table or vertical device), crutching, electrophoresis, and laser therapy help improve the condition.
Medications for the treatment of osteochondrosis of the lumbar spine are administered internally and topically. Topical gels and ointments are a symptomatic therapy: they relieve inflammation and pain, relieve muscle cramps and edema, and improve blood circulation. In acute conditions, injections are shown that have an immediate anti-inflammatory, antipyretic, analgesic effect.:
Most doctors prescribe home medications for osteochondrosis:
- Chondroprotectors- protect cartilage tissue and help it regenerate, recommended for long-term use (six months or more).
- Devices that improve blood circulation and metabolic processes in tissues- tablets that are taken for several months because the effect is cumulative.
- Muscle relaxants- relieves muscle cramps, applied orally in the short term.
- Non-steroidal anti-inflammatory drug- quickly blocks pain, suppresses the production of prostaglandins involved in the inflammatory process. Ointments and gels are applied to the affected area 1-2 times a day unless otherwise instructed. In the initial stage, the external forms can be dispensed with and then duplicated with tablets.
- Corticosteroids- Analgesic injections are prescribed only in the absence of significant effects of non-steroidal drugs.
- Warming ointments- help relieve pain and improve tissue blood circulation, are safer than NSAIDs, but are prohibited in the inflammatory process.
- Group B vitaminsand multivitamin complexes are prescribed in the long term to increase the overall effectiveness of treatment.
Physiotherapy courses may be prescribed to the patient to enhance the effect of medication and accelerate recovery. You can alternate them or experience more than one opportunity at a time. The specific technique is chosen according to the stage and form of the disease.
Lumbar spine osteochondrosis - effective treatments include:
- Electrotherapy (electrophoresis)- includes the effect of low-power electric currents to improve blood circulation in the affected areas.
- Laser therapy- activates the biological processes of nerve endings, relieves the symptoms of neurodystrophic syndrome.
- UHF- a local effect on the lumbar region with a high-frequency magnetic field to stop the inflammatory process, regenerate (restore) tissue cells, and reduce pain.
- Phonophoresis and Electrophoresis- Helps deliver medications to areas in need, which increases the effectiveness of medication. The result depends on the specific agent used in the procedure.
- Darsonvalization- the therapeutic effect of high-frequency alternating current to dilate blood vessels, improve blood circulation and tissue nutrition. The procedure affects the symptoms less than others.
- Amplipulse- a local effect of sinusoidal modulated currents that reduces the severity of pain. The procedure has an analgesic effect, dilates blood vessels, neurostimulates and improves the trophism of tissues.
Physical activity, especially in the case of early (initial) lumbar spine osteochondrosis, should be included in the treatment: they help to relax and strengthen the muscles and have a beneficial effect on the nutrition of the tissues. For those with grade 2 disease and more severe exercise, it is selected by your doctor. In case of aggravation, gymnastics, swimming, yoga (the most effective directions) are prohibited.
The following exercises show good results:
- Focus on your knees and palms, keeping your back straight (parallel to the floor). When exhaling, slowly bend the lumbar region, tilting your head back slightly. Count to 5-8 (depending on how you feel), inhale and arch your back with a wheel. Count to 5-8 again and take out the starting position. The exercise is performed 10-12 times at a slow pace. If necessary, they are divided into 2-3 approaches.
- Lie on your stomach. When exhaling, slowly tear your chest off the floor, lean on your lower back, and try to rise as high as possible. The arms are extended forward, the legs do not move. Hold this position for 5-10 seconds and gradually descend. Repeat the exercise 8-10 times, gradually increasing the duration of the delay at the top point.
MassageMassage is an effective method to treat any stage of osteochondrosis that helps relieve unpleasant symptoms, remove muscle cramps, normalize lymph outflow and blood supply to the affected areas. This procedure stimulates the recovery of atrophic muscles and removes restrictions on the mobility of vertebrae, strengthening the ligament equipment. The massage is performed by a specialist 10-12 times when the symptoms of the acute stage have alleviated.
If a patient is diagnosed with a major neurological disorder, loss of urinary control is severe hernial protrusion, surgery is required. In addition, its indication is the lack of a positive effect of conservative treatment (lasting more than a month). Before receiving a referral for surgery, the physician must assess all the risks, especially if traditional technology is chosen over microdiscectomy.
During the procedure, the surgeon:
- remove the abnormally altered areas by placing local implants (discectomy) on them that are developed individually for each patient;
- Aligning the spine with a special bar - this helps to distribute the load correctly and prevent new deformations.
Discectomy is performed under general anesthesia with the surgeon’s back access. During surgery, the skin is cut to a length of 10 cm, the muscles are separated, and the affected disc is removed. At the end of the procedure, the wound is sutured in layers. The duration of the surgery is about 2 hours, the next day the patient should lie on his back. The rehabilitation period is 2 months. With microdiscectomy, the procedure takes 1. 5 hours, the incision is made at 3 cm, and it can rise after leaving the anesthesia.
Treatment of lumbar spine osteochondrosis with folk remedies
The use of traditional medicine prescriptions is permitted after consultation with a physician who is able to properly assess the patient's condition. They do not give the same pronounced effect as drug therapy, they do not replace physiotherapy, massage, and gymnastics, but they increase the likelihood of positive treatment from the main treatment.
Here are some simple options:
- Grate the peeled black radish (350 g), mix with liquid honey (250 g) and vodka (100 ml). Use light back massage movements on the lower back for 10 minutes in the morning and evening. It is then advisable to cover this area with a woolen cloth and lie under a blanket for an hour. The procedure is performed for 8-10 days, after which there is a break.
- In case of severe low back pain, you can take 100 g of medium-fat cottage cheese, add 1 tbsp. apple cider vinegar, put on cotton cloth or cheesecloth. The dressing is maintained for 2 hours, the procedure being repeated twice a day if necessary. The duration of treatment is not limited.
- Collect fresh purple flowers, fill them with a liter pot without crushing. Pour a liter of vodka, leave in a cool place for 3 weeks. Use to rub the affected area once a day, once a month. It is not necessary to cover the lower back with anything after processing.
Prevention of lumbar spine osteochondrosis
Doctors say most back diseases can be prevented with regular physical activity, which strengthens muscles, improves blood circulation and nourishes tissues. Lumbar spine osteochondrosis is no exception - treatment does not need to be done if you systematically practice gymnastics, yoga and swimming.
Additional preventive measures:
- diet control (more plant food, less animal fat, pickles, marinade: as in treatment);
- limits severe load on the spine;
- monitoring the state of the endocrine system;
- elimination of bad habits (alcohol, smoking);
- use of an orthopedic mattress;
- posture tracking;
- Avoid women's high heels (from 7 cm).