Back and lower back pain is one of the most common complaints in medicine.In terms of the total number of requests, they are in second place, only after respiratory diseases.A wide variety of pathologies can cause pain in the lower back, but very often it is caused by osteochondrosis of the lumbar region.Below we will discuss how to treat such a disease, what are its symptoms and signs.
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, the age symptom is not exclusive;Osteochondrosis of the lumbar spine is diagnosed in different age groups.Nowadays, the cut-off age is more than 25 years.
Causes of lumbar osteochondrosis
The exact reason is impossible to name;there will almost always be a complex effect of various destructive factors, the most important of which can be identified:
- Commitment to a passive lifestylein terms of motor activity.By their own will, immobilized people who, for example, spend many hours in front of the computer, do not receive enough useful load, therefore the muscles of the "corset" relax and the load on the vertebrae increases.In addition, such pastime is almost always 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 includes diseases of an endocrine nature.
- The presence of congenital or acquired abnormalitieswhen the musculoskeletal system undergoes certain changes.This can be reflected in an increased load on the spine, for example in patients with flat feet, curvature of the legs or spine.
- Chronically increased loadin the lower back.Here, the risks include people who engage in certain types of professional activities, usually heavy lifting.This also includes professional athletes who constantly expose their bodies to peak loads.
- Disturbed food intake and daily routine.This includes regular exposure to stress.These factors influence the processes of metabolism and affect 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, this can manifest itself in several ways, initially causing practically no symptoms, or causing pain that is difficult to tolerate during late development.Consider the main stages of the development of osteochondrosis:
- A condition in which the nucleus pulposus moves within 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, shooting, or constant dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the elements of the spinal column in this area increases and they become unstable in relation to each other.In order to eliminate these pathological manifestations, it is necessary to constantly keep the muscles of this area tight, which eventually leads to chronic fatigue in the lower back.
- After that, there is a breakthrough in the fibrous annulus, as a result of which the nucleus reaches beyond the border of the disc and forms an intervertebral hernia.Such a case is accompanied by pinching of the nerve endings, which is called "radicular syndrome".
- The next stage 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, disappears at this stage.However, one should not rejoice;it does not mean that the disease will die out.
- The last stage is characterized by abnormal growth of bone tissue and general deterioration of health.
Depending 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, the sensation of pain, their localization and the direction of their spread may change.This is due to the fact that depending on the degree of damage to the intervertebral disc and surrounding tissues, certain nerve receptors are irritated.In addition, the protrusion itself or the presence of the hernia, the direction of protrusion and many other factors play a role.
The main symptoms of osteochondrosis of the lumbar spine are:
- The presence of painful pain in the lower back, which intensifies with sudden movements, or, on the contrary, the situation does not change for a long time.The pain goes away when you assume a horizontal position.
- In addition, weakness in the lower abdominal area of the body, including the lower limbs, and dull tendon reflexes in the legs are likely.
- There is a high probability of curvature in the lumbar spine.There is a classification of such curvatures, for example, when the emphasis is on the right or left side, it is called scoliosis, lordosis is the position of bending forward, and kyphosis is the case when the natural lumbar curve is somewhat smoothed out.
- In the case of a severe development of the disease, pinching of the canals of the spinal cord is possible, which can cause functional disorders and lead to uncontrolled urination and defecation.
Other symptoms include:
- The presence of numbness and "coldness" of the skin of the lower back and buttocks.
- Mottled, dry and blue skin in the same places.
- Impaired urination.
- Erectile problems.
The presence of these symptoms should alert the person;you must not give them up, this only leads to greater neglect.In this case, you should definitely consult a doctor for accurate diagnosis and treatment.The treatment can be done either in hospital or 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 to identify painful areas is to palpate the lumbar region.In general, this method is not very informative, and in addition, tests are carried out that give a more detailed clinical picture:
- Based on radiography, an inexpensive and widely used method, the condition of both the spine as a whole and individual vertebrae, such as the lumbar region in question, can be assessed.The technique is not very precise;it only indirectly allows us to understand how intact the intervertebral discs and spinal canals are.
- Computed tomographya more accurate method that allows the degree of damage to the vertebrae, nerve roots and discs between the canals of the spinal cord.
- Magnetic resonance imagingit is the most accurate method, it gives a complete picture of the lesion in detail, but it is quite expensive and inaccessible.
It should be noted that the diagnostic process is very important, since every detail of the developed osteochondrosis is 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 pinched spinal canals.
- Functional disorders in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When osteochondrosis of the lumbar spine is diagnosed, extensive therapy is required, the main aspects of which are as follows:
- Application of moderate load.
- Special medicines.
- Traction of the spine.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of "treatment" of osteochondrosis includes:
- Reducing inflammation.
- Alleviation of pain syndrome.
- Complex for strengthening the lumbar and adjacent muscle groups.
- Relief from chronic muscle tension.
- Increasing the functioning 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 involves taking medications, injections of special drugs, and the use of 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:
- Painkillers with analgesic effect.
- Nonsteroidal anti-inflammatory drugs.
- For muscle spasms, antispasmodics.
- Medicines for the restoration of cartilage tissue, called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in traditional medicine.
- In case of severe pathologies, if the above remedies do not help, corticosteroids should be used.
- Vitamin complexes.
In addition to these drugs, drugs are prescribed in the form of tablets, which are designed to calm the nervous system and combat 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 recovery processes of the spine.For this purpose, a wide range of physiotherapy procedures are used, the most popular of which are:
- Phonophoresis.
- Therapy with diadynamic currents.
- Laser therapy.
In addition, the spine must be given a useful load, while at the same time it must be stretched.Various therapeutic massages are ideal for this.It should be remembered that massage is used only when the pain is alleviated.It is usually performed as a restorative measure when the remission process of the disease has begun or in chronic osteochondrosis.After a massage, the muscles overstretched by the disease relax well;its effect is significantly enhanced if it is heated at the same time, for example in a bath or sauna.In the latter case, the maximum effect is achieved due to further stimulation of blood circulation in the pathological zone and adjacent areas.
Another form of physical therapy is manual therapy.Its benefits are generally the same as those of massage, but in addition, with the help of such techniques, the specialist can restore the displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercises are also used as restorative and preventive measures in the period when pain and inflammation have subsided.The key to the high efficiency of therapeutic exercises is the regularity of the exercises;In this case, the damaged area continuously receives the necessary physical activity for the self-formation of new tissues and healing.
Surgical operations in lumbar osteochondrosis
Surgery is the last option prescribed in case of severe complications.The most common of these is intervertebral hernia, when a so-called "discectomy" or removal of the affected intervertebral disc is performed.Surgery is very effective, but it is prescribed as a last resort only when other therapeutic methods have failed for more than 6 months.Modern medicine also offers less traumatic methods of performing such operations, such as microsurgery or endoscopic methods.