Osteochondrosis is a widespread disease of the spine, which affects the intervertebral discs and cartilage. The cervical and lumbar regions are most susceptible to such processes. Osteochondrosis of the lumbar region can cause constant pain in the lower back and significantly complicate a person's life. In the treatment of the disease, preference is given to conservative methods, surgical intervention is resorted to only in extreme cases.
Causes of lumbar osteochondrosis.
Osteochondrosis is not so much a disease as often a natural phenomenon that occurs as a result of age-related degenerative changes in the spine. Normally, the lumbar spinal disc acts as a shock absorber between two vertebrae and allows the joints and spine to move easily. The outer part of the disc, the annulus fibrosus, surrounds the soft inner core of the disc, the nucleus pulposus. Every person's spinal discs undergo degenerative changes as they age, but not everyone develops symptoms.
Osteochondrosis is thought to begin with changes in the annulus fibrosus, intervertebral disc, and subchondral bone. The annulus fibrosus loses water, which makes it less capable of supporting the daily loads on the spine, distributing them incorrectly. Overload of the posterior part of the vertebra causes arthritis of the facet joints and hypertrophy (growth, with the formation of osteophytes, bone growths) of the vertebral bodies adjacent to the affected disc.
Reference! According to statistics, 30% of people between 30 and 50 years old have some degree of spinal disc degradation.
There are two main pathophysiological causes of pain in lumbar osteochondrosis. One of the possible causes of pain is inflammation of the nerves as a result of the outer part of the disc rupturing and the inner core leaking. Inflammatory proteins are released that irritate nervous tissue.
According to the second reason, the vertebrae, due to age-related deformation, can no longer absorb the load effectively. This causes abnormal movement of the spine and causes a painful spasm of the back muscles that try to stabilize the spine.
The result of osteochondrosis can be the destruction of segments of the spine, causing radiculitis. The risk factors that trigger and accelerate degenerative processes in the spine are:
- Hereditary predisposition to diseases of the musculoskeletal system;
- Of smoking;
- Previous injuries;
- Hormonal and vascular disorders;
- Excess body weight;
- Muscles that are too weak and do not provide the necessary support to the spine;
- Professional activities associated with heavy physical work (athletes, porters).
Stages of development of lumbar osteochondrosis.
Disorders in the intervertebral discs, leading to their degeneration and destruction, occur gradually. The entire pathological process goes through several stages, according to which the stages (or degrees) of lumbar osteochondrosis are distinguished:
- The first stage (grade) is characterized by mild symptoms. Painful sensations develop against the background of irritation of the nerve endings by the nucleus pulposus, which penetrates into the cracks of the annulus fibrosus.
- The second stage is characterized by the displacement of the upper vertebra with respect to the lower one, due to cracking of the nucleus and the annulus. These pathological processes, in addition to pain during movement, cause the appearance of neurological symptoms, a feeling of numbness and instability of the affected area.
- The third stage is characterized by increased pain and the appearance of intervertebral disc herniations, due to a violation of the integrity of the annulus fibrosus. Pain, sensory impairment, and muscle weakness interfere with daily tasks. Due to pinching of the nerve roots, the functioning of the urinary and intestinal systems may be disturbed.
- The fourth stage corresponds to the complete destruction of the intervertebral discs, they become fibrotic, and osteochondral growths of the vertebral bodies cause immobility of the spine in this section.
Symptoms of lumbar osteochondrosis.
To get started, get advice from specialists:
- Neurologist
- Orthopedist
- Therapist
The main symptom of lumbar and sacral osteochondrosis is pain. It usually worsens when sitting for long periods of time, or when rotating, bending the spine, or lifting a load. The pain may radiate to the leg, groin and be accompanied by a feeling of numbness and weakness. Moderate, aching, dull pain may be followed by exacerbation attacks.
Symptoms directly depend on the stage of development of the pathology:
- In the initial period, when degenerative changes are just beginning to appear, symptoms are minimal.
- The intermediate stage, which is characterized by the weakening of the annulus fibrosus, can already manifest as low back pain.
- In the later stage, when fibrosis develops in the structures and osteophytes form, the pain becomes less pronounced, but the mobility of the spine decreases significantly.
Sensitivity in the lower back may increase when touched. The characteristic shooting pains in the buttocks, thighs and tingling sensation are a sign of impingement of the nerve roots that occurs as a result of degenerative changes in the disc. Patients with lumbar osteochondrosis have difficulty bending forward, backward, and sideways. Osteochondrosis can be complicated by herniated discs and narrowing of the spinal canal, accompanied by the appearance of additional symptoms.
Diagnosis of lumbar osteochondrosis.
Making a diagnosis begins with taking a history, interviewing and examining the patient. The specialist will be interested in your complaints, physical activity, presence of old injuries, bad habits and cases of illness in close relatives. During a physical exam, the doctor palpates (feels) the lower spine, looking for tender areas, swelling, or any abnormalities. He can also check sensations and perform motor tests.
The most popular method of diagnosing lumbar osteochondrosis is X-ray examination. The image will show the presence of osteophytes, narrowing of the joint space of the disc or the so-called "void" symptom, when gas bubbles are detected in the thickness of the disc . Other methods used are:
- MRI shows hydration (the degree of water saturation), the shape of the discs, their height, which makes it possible to identify pinched nerves.
- Computed tomography, which makes it possible to study the state of tissues in detail and diagnose disorders in the early stages.
- Provocative discography used to determine the location of the affected disc.
Reference! MRI is a fairly accurate diagnostic method, but it cannot detect rupture of the outer rings of the disc.
Treatment methods for lumbar osteochondrosis.
The preferred treatment for lumbar degenerative disc disease associated with chronic pain is conservative treatment with physical therapy, exercise, and medications. For patients with lumbar osteochondrosis it is recommended:
- A daily routine that includes enough rest and appropriate physical activity;
- Regular physical exercise aimed at strengthening muscles;
- Lifestyle adjustments, including nutritional review and weight loss.
Physiotherapy
Various physiotherapeutic techniques have been used successfully to reduce low back pain. Physiotherapy promotes regenerative processes in the disc, stimulates metabolic and transport processes, prevents the formation of adhesions and further damage.
Physiotherapeutic methods used to treat spinal osteochondrosis include:
- Electrical stimulation. The electrical impulses help relieve back pain and improve blood circulation in the affected spine.
- Ultrasound therapy. Ultrasound waves can penetrate deep layers of tissue and help relieve inflammation and pain.
- Magnetotherapy. Magnetic fields can improve blood circulation and metabolic processes in tissues, promoting their regeneration.
- Laser therapy. Lasers can help relieve pain, stimulate blood circulation, and stimulate tissue regeneration.
- Ultraphonophoresis. This method combines ultrasound therapy with the use of medications that penetrate deep layers of tissue and help relieve inflammation and pain.
Important! Contrary to popular belief, osteochondrosis can and should be treated. Without treatment, it will become a source of chronic pain and can lead to numerous problems, including impaired functioning of internal organs.
Pharmacotherapy
To relieve pain that interferes with daily activities, patients are prescribed pain relievers and nonsteroidal anti-inflammatory drugs. Depending on the indications, the doctor may prescribe stronger medications: muscle relaxants, steroids, and narcotic pain relievers. Therapeutic blocks are administered with local anesthetics and glucocorticoids to relieve severe pain.
Surgery
Much less often, surgical intervention is used for osteochondrosis of the lumbar region. It may include disc arthroplasty or fusion of the lumbar spine (creating the conditions for the fusion of two vertebrae, while reducing pain by eliminating movement in this part of the spine).
If the movement of the spine is significantly affected, special intervertebral spacers can be installed. For patients who do not respond to all other treatments, a total lumbar disc replacement may be performed.
Treatment of lumbar osteochondrosis at home.
The most effective thing you can do at home to maintain function and control pain is to exercise. They will increase the flow of blood, oxygen and nutrients to the spine, helping to keep the cartilage hydrated and the spine flexible for as long as possible. Additionally, endorphins, which are natural pain relievers, are released during exercise.
Frequent changes in position also provide relief. Some postures help to cope with a pain attack: kneeling, reclining, lying down. A short rest is necessary and beneficial, but prolonged bed rest only worsens the condition. It is important to stay active to prevent the disease from progressing. Patients with lumbar osteochondrosis benefit from walking, swimming, cycling, yoga, Pilates, stretching exercises and strengthening the muscle corset. The following measures also help:
- Applying heat to the lower back improves blood circulation and relieves muscle spasms and tension.
- Ice packs will help relieve pain and reduce inflammation.
- Massage also relaxes muscles, relieves spasms and reduces pressure on the spine, thus relieving pain. By increasing blood circulation in this area, metabolic processes are improved and tissues are enriched with oxygen.
- Use of orthopedic mattresses and pillows. They will help maintain the correct position of the spine during sleep.
- Correct distribution of the load on the column. When lifting heavy objects, you should use proper lifting technique to avoid stressing the lumbar spine.
- Proper nutrition. Eating a balanced diet rich in calcium and vitamins will help maintain healthy bones and joints.
However, if you experience pain or other symptoms, before starting treatment for osteochondrosis at home, you should consult your doctor for more precise recommendations and assess the condition of the spine.
Which doctor should I contact if I have lumbar osteochondrosis?
If symptoms characteristic of lumbar osteochondrosis appear, it is recommended to consult a neurologist or orthopedic doctor. If you have lower back pain, you can also make an appointment with a therapist. He will prescribe the necessary tests to make a diagnosis and refer you to a specialist.
Treatment of lumbar osteochondrosis.
Specialists from the clinic closest to your city or other locality are ready to understand the reasons and help cope with the pain. Doctors usually have extensive clinical experience and master all modern methods of treatment and diagnosis of osteochondrosis in women and men. For the most part, convenient location, excellent equipment and versatility of institutions are a priority of modern medicine, allowing you to quickly undergo any examination and restore the health of the musculoskeletal system. You can make an appointment by calling the clinic that is most convenient for you, as well as on the website by filling out the online form.
Prevention of lumbar osteochondrosis.
Effective methods to prevent lumbar osteochondrosis are:
- Regular physical activity. Stay in good physical shape. Strengthen your back muscles. Back stretching and strengthening exercises will help keep your spine healthy.
- Reduce stress on the spine: Avoid unnecessary stress on the spine. When lifting heavy objects, use proper lifting technique.
- Posture correction: ensure correct posture. Sit and stand up straight, don't slouch. Choose an orthopedic pillow and mattress for sleeping to maintain the correct position of the spine while resting. Buy quality shoes with good cushioning and support.
- Take care of your back support by using orthopedic chairs if, due to the nature of your profession, you are forced to remain seated for long periods of time. Avoid staying in one position for a long time. Take regular breaks and stretch your spine.
- Watch your weight. Excess weight can place additional stress on the spine.
- Avoid uncontrolled movements and back injuries. Be careful when playing sports or physical activity.
- Stop smoking, which can negatively affect your spinal health.
By following a few simple recommendations you can live an active and full life, minimizing the risks of back pain. If you already have symptoms of lumbar spine pain, be sure to see a doctor for diagnosis and treatment.