Back and lower back pain is one of the most common complaints in medicine.They are second in number of all requests, second only to respiratory diseases.A wide variety of pathologies can cause pain in the lower back, but very often this is due to osteochondrosis of the lumbar region.How to treat such a disease, what symptoms and signs it has, 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.Today, however, ageism is not exclusive;Osteochondrosis of the lumbar spine is diagnosed in patients of different age groups.Today, the cut-off age is believed to be over 25.
Causes of lumbar osteochondrosis
It is impossible to name the exact reason;almost always it will be the complex impact of various destructive factors, among which the most important can be identified:
- Commitment to a passive lifestylein terms of motor activity.Immobilized people of their own volition, for example, spending many hours in front of the computer, do not receive enough useful load, due to which the muscles of the "corset" relax and the load on the vertebrae increases.In addition, almost always such entertainment is associated with prolonged exposure to incorrect and unnatural positions.
- Problems with hormone levels, which leads to metabolic disorders, which affects the metabolism of spinal tissue in the lumbar region and contributes to destructive processes.This also includes diseases of an endocrine nature.
- Presence of congenital or acquired anomalieswhen the musculoskeletal system undergoes certain changes.This can be reflected in an increased load on the spine, for example in a patient with flat feet, curvature of the legs or spine.
- Chronically increased loadson the lower back.Here, the risks include people with certain types of occupational activities, usually related to lifting weights.This also includes professional athletes who constantly subject their bodies to peak loads.
- Disturbed food intake and daily routine.This also includes regular exposure to stress.These factors affect metabolic processes and have an impact on 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 unbearable pain in the late development.Let's consider the main stages of development of osteochondrosis:
- A condition where the nucleus pulposus moves into the intervertebral disc.It is characterized by pain caused by irritation of the nerve roots of the annulus fibrosus and longitudinal ligaments.Local discomfort is felt in the area where the defective disc is located.The pain can be sharp with shooting or constant dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the elements of the spine in this area increases, they become unstable relative to each other.In order to eliminate these pathological manifestations, it is necessary to constantly keep the muscles of this area tense, which ultimately leads to chronic fatigue in the lower back.
- A breach in the annulus fibrosus then occurs, causing the nucleus to protrude beyond the disc border, 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 appear, but the pain syndrome, oddly enough, subsides at this stage.However, you should not rejoice;it does not mean that the disease is dying.
- The last stage is characterized by pathological growth of bone tissue and general deterioration of 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 can vary.This is due to the fact that based on the degree of damage to the intervertebral disc and surrounding tissues, certain nerve receptors are irritated.In addition, the presence of a protrusion or the hernia itself, the direction of the protrusion and many other factors play a role.
The main symptoms of osteochondrosis of the lumbar spine include:
- The presence of aching pain in the lower back, which tends to increase with sudden movement or, conversely, remaining without changing the position for a long time.The pain subsides if you take a horizontal position.
- In addition, there is likely to be weakness in the area of the body below the abdomen, including the lower limbs, as well as a dulled tendon reflex in the legs.
- There is a high probability of curvature of the lumbar spine.There is a classification of such distortions, for example, when the emphasis is on the right or left side, they talk about scoliosis, lordosis is the situation of bending forward, and kyphosis is the case when the natural lumbar curve is, so to speak, smoothed out.
- With a serious degree of development of the disease, pinching of the canals of the spinal cord is possible, which can cause dysfunction and lead to uncontrolled urination and defecation.
Additional symptoms include:
- Presence of numbness and "coldness" of the skin of the lower back and buttocks.
- Scaly, dry and blue skin in the same places.
- Impaired urination.
- Erection problems.
The presence of these symptoms should alert a person;you should not give them up, it will only lead to more neglect.In this case, you should definitely consult a doctor for an accurate diagnosis and treatment.By the way, treatment can be both in a hospital setting and at home, but more on that a little later.
Diagnosis of the disease
When making a diagnosis, it is important to understand to what extent the disease has progressed.The easiest way is palpation in the lumbar region to identify areas of pain.Usually, this method is not very informative, and in addition, studies are conducted that give a more detailed clinical picture:
- By radiography, an inexpensive and widespread method, it is possible to assess the condition of both 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 know 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.
- Nuclear magnetic resonancethe most accurate method, gives a complete picture of the lesion in detail, but is quite expensive and unavailable.
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 the pathology are hernias and protrusions, which inevitably appear 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 pinched spinal canals.
- Functional disorders in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When diagnosing 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.
- Traction of the spine.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of "treatment" of osteochondrosis implies:
- Suppressing inflammation.
- Pain relief.
- Complex for strengthening the lumbar and adjacent muscle groups.
- Relief from chronic muscle tension.
- Increasing the functionality of the organs in the small pelvis.
- Normalization of blood circulation and metabolism in the pathological area.
Drug treatment
A similar approach to the treatment of lumbar osteochondrosis includes taking drugs, injections with special drugs and using ointments and gels for external use.The main task of such drugs 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 drugs:
- Analgesics that have an analgesic effect.
- Anti-inflammatory drugs of non-steroidal origin.
- For muscle spasms, antispasmodics.
- Medicines to restore cartilage tissue called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in traditional medicine.
- In serious pathologies, when the above means do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these drugs, drugs are prescribed in the form of tablets, the purpose of which is to calm the nervous system and fight stress and depression.
Physiotherapy treatment of lumbar osteochondrosis
The treatment process is rarely limited to just taking pills.The pathology in question cannot be cured without stimulating the restorative processes of the spine.A wide range of physiotherapy procedures are used for these purposes, the most popular of which are:
- Phonophoresis.
- Diadynamic current therapy.
- Laser therapy.
In addition, the spine should receive useful loads while stretching it.Various types of massage therapy are ideal for this.It should be remembered that massage is used only 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 begun or in case of chronic osteochondrosis.After a massage, the muscle muscles, overstrained by illness, are well relaxed;its effect will be greatly enhanced with simultaneous heating, for example in a bath or sauna.In the latter case, we will achieve the maximum effect due to additional stimulation of blood circulation in the area of pathology and adjacent areas.
Another method of physical therapy is manual therapy.Its advantages are generally the same as those of massage, but in addition, with the help of such techniques, the specialist can return the displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercises are also used as a restorative and preventive measure in the period when pain and inflammation have already been alleviated.The key to the high effectiveness of therapeutic exercises is the regularity of the exercises;in this case, the damaged area will constantly receive the necessary physical activity for self-generation of new tissue and recovery.
Surgical operations in lumbar osteochondrosis
Surgery is a last resort that is prescribed for serious complications.The most common of these is intervertebral hernia, when a so-called "discectomy" or removal of the affected intervertebral disc is performed.The operation is very effective, but as a last resort, it is prescribed only if other methods of treatment have failed for more than 6 months.Modern medicine also offers less traumatic methods for performing such an operation, for example, microsurgical or endoscopic methods.