Back and lower back pain is one of the most common complaints in medicine.They are in second place in number of requests, second only to respiratory diseases.A wide variety of pathologies can cause pain in the lower back, but it is often caused by osteochondrosis of the lower back.How to treat this disease, what symptoms and signs it presents, will be discussed below.
Not so long ago, medical science believed that osteochondrosis in the lumbosacral region occurs solely due to age-related changes that lead to wear and tear of the vertebrae and intervertebral discs.However, today the symptom of age is not exclusive;osteochondrosis of the lumbar spine is diagnosed in patients of different age groups.Today, the age limit is considered to be over 25 years old.
Causes of lumbar osteochondrosis
It is impossible to name the exact reason;It will almost always be the complex impact of several destructive factors, among which the most important can be identified:
- Commitment to a passive lifestylefrom the point of view of motor activity.Of their own free will, immobilized people, for example, who spend many hours at the computer, do not receive enough payload, as a result of which the “corset” muscles relax and the load on the vertebrae increases.Furthermore, this pastime is almost always associated with prolonged exposure to incorrect and unnatural positions.
- Problems with hormone levels, leading to metabolic disorders, which affect the metabolism of the spinal tissue of the lumbar region and contribute to destructive processes.This also includes diseases of an endocrine nature.
- Presence of congenital or acquired anomalieswhen the musculoskeletal system undergoes certain changes.This may be reflected in increased load on the spine, for example, in a patient with flat feet, curvature of the legs or spine.
- Chronic increased loadsin the lower back.Here, the risks include people with certain types of professional activities, generally associated with heavy work.This also includes professional athletes who constantly subject their bodies to peak loads.
- Disrupted food intake and daily routine.This also includes regular exposure to stress.These factors affect metabolic processes and influence the periodic restoration of the body's strength.
Degrees of osteochondrosis of the lumbar spine
The above pathological factors gradually lead to the manifestation of the disease.However, it can manifest itself in different ways, being practically asymptomatic at the beginning or causing barely tolerable pain at the end of development.Let's consider the main degrees of development of osteochondrosis:
- Situation in which the nucleus pulposus moves within the intervertebral disc.It is characterized by pain caused by irritation of the nerve roots of the fibrous ring and longitudinal ligaments.Discomfort is felt locally in the area where the defective disc is located.The pain may be sharp with constant stabbing or dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the spinal elements in this area increases, making them unstable with each other.To eliminate these pathological manifestations, it is necessary to constantly keep the muscles in this area tense, which ultimately leads to chronic fatigue in the lower back.
- Then, a rupture occurs in the fibrous ring, which causes the nucleus to escape beyond the edge of the disc, forming an intervertebral hernia.Such a case will be accompanied by pinching of the nerve endings, which is called “radicular syndrome”.
- The next degree of osteochondrosis of the lumbosacral region occurs with severe deformation of the spine in this part.Mobility problems arise, but the pain syndrome, oddly enough, subsides at this stage.However, you shouldn't rejoice;This does not mean that the disease is going away.
- The last degree is characterized by pathological growth of bone tissue and general deterioration in health.
Based on the degree of lumbar osteochondrosis, certain treatment methods are used.
Symptoms of osteochondrosis in the lower back
The main symptom is combat syndrome in the lumbar spine.At the same time, pain sensations, the area of their localization and the direction in which they spread may vary.This is because, based on the degree of damage to the intervertebral disc and surrounding tissues, certain nerve receptors become irritated.In addition, the presence of a protrusion or the hernia itself, the direction of its protrusion and many other factors play a role.
The main symptoms of osteochondrosis of the lumbar spine include:
- Presence of pain in the lower back, which tends to intensify with sudden movements or, on the contrary, without changing position for a long time.The pain decreases if you assume a horizontal position.
- Additionally, there is likely to be weakness in the area of the body below the abdomen, including the lower extremities, as well as a dull tendon reflex in the legs.
- There is a high probability of curvature in the lumbar spine.There is a classification of these curvatures, for example, when the emphasis is on the right or left side, they talk about scoliosis, lordosis is the situation of forward bending and kyphosis is the case when the natural lumbar curve is, so to speak, softened.
- With a severe degree of development of the disease, it is possible to pinch the spinal cord channels, which can cause their dysfunction and lead to uncontrolled urination and feces.
Additional symptoms include:
- The presence of numbness and “coldness” in the skin of the lower back and buttocks.
- Scaly, dry, bluish skin in the same places.
- Impaired urination.
- Erection problems.
The presence of these symptoms should alert the person;You shouldn't give up on them, this will only lead to greater neglect.In this case, you should definitely consult a doctor for accurate diagnosis and treatment.In fact, treatment can be both in a hospital setting and at home, but more on that later.
Diagnosis of the disease
When making a diagnosis, it is important to understand how far the disease has progressed.The easiest way is to palpate the lower back to identify areas of pain.Normally this method is not very informative and in addition exams are carried out that give a more detailed clinical picture:
- By x-ray, an inexpensive and widespread method, it is possible to assess the condition of the spine as a whole and individual vertebrae, for example, the lumbar region in question.The technique is not very precise;it only allows us to indirectly understand how intact the intervertebral discs and spinal canals are.
- Computed tomographya more accurate method that allows you to assess the level of damage to the discs between the vertebrae, nerve roots and canals with the spinal cord.
- MRIthe most accurate method, provides a complete and detailed image of the lesion, but is quite expensive and inaccessible.
It should be noted that the diagnostic process is very important, since all the details of the developed osteochondrosis are important for the doctor when prescribing treatment tactics.
Complications of osteochondrosis
The main complications of pathology are hernias and protrusions, which inevitably occur if treatment is neglected and the development of the disease is left to chance.Other complications may include:
- Inflammation of the sciatic nerve.
- Spondyloarthrosis.
- Schmorl's hernia.
- Spondylosis.
- Problems caused by compressed spinal canals.
- Functional disorders in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When diagnosed with osteochondrosis of the lumbar spine, a wide range of therapies is required, the main aspects of which will be:
- Application of moderate loads.
- Special medicines.
- Spinal traction.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of “treatment” for osteochondrosis implies:
- Suppression of inflammation.
- Relief of pain syndrome.
- Complex for strengthening the lumbar and adjacent muscle groups.
- Relief from chronic muscle tension.
- Increasing the functionality of the pelvic organs.
- Normalization of blood circulation and metabolism in the pathological area.
Drug treatment
A similar approach to the treatment of lumbar osteochondrosis includes the use of medications, injections of special medications, and the use of ointments and gels for external use.The main task of these medications is to neutralize pain and inflammation.
Based on the degree of osteochondrosis of the spine in the lumbar region, the doctor may prescribe the following medications:
- Analgesics that have an analgesic effect.
- Medicines against inflammation of non-steroidal origin.
- For muscle spasms, antispasmodics.
- Medicines for the restoration of cartilaginous tissue, called chondroprotectors.Their effectiveness has not been proven, which is why they are rarely used in traditional medicine.
- For serious pathologies, when the above remedies do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these medications, tablet medications are prescribed that aim to calm the nervous system and combat stress and depression.
Physiotherapy treatment for lumbar osteochondrosis
The treatment process is rarely limited to just taking pills.The pathology in question cannot be cured without stimulating the restoration processes in the spine.To this end, a wide range of physiotherapeutic procedures are used, the most popular of which are:
- Phonophoresis.
- Therapy with diadynamic currents.
- Laser therapy.
Furthermore, the spine needs to receive payloads and at the same time lengthen it.Various types of massage therapy are ideal for this.It must be remembered that massage is only used when the pain is relieved.As a rule, it is carried out as a restorative measure when the process of remission of the disease has already begun or in chronic osteochondrosis.After a massage, the muscular muscles overloaded by the disease are well relaxed;its effect will be significantly enhanced when heated simultaneously, for example, in a bathhouse or sauna.In the latter case, we will achieve the maximum effect due to additional stimulation of blood circulation in the pathological zone and adjacent areas.
Another method of physical therapy is manual therapy.Its advantages are generally the same as massage, but in addition, with the help of these techniques, the specialist can return the displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercises are also used as a restorative and preventative measure during the period when pain and inflammation have already been relieved.The key to the high effectiveness of therapeutic exercises is the regularity of the exercises;In this case, the injured area will constantly receive the physical activity necessary for the self-generation of new tissues and recovery.
Surgical operations for lumbar osteochondrosis
Surgery is a last resort, prescribed for serious complications.The most common of these is intervertebral hernia, when the so-called “discectomy” or removal of the affected intervertebral disc is performed.The operation is very effective, however, being a last resort measure, it is prescribed only if other methods of therapy fail for more than 6 months.Modern medicine also offers less traumatic methods for carrying out such an operation, for example, microsurgical or endoscopic methods.