Osteochondrosis of the lumbar spine is a pathological change in the cartilage and bone tissue of the intervertebral discs in the lumbosacral spine. This change can be natural or the result of an unhealthy lifestyle. In old age, involutional processes of bone and cartilage tissue begin in all people. But when these phenomena are premature (occur in middle-aged people), then we are talking about pathological processes of the skeletal system. The pathology affects both men and women over 30 years of age.
Lumbar osteochondrosis is the most well-known and common disease of the spine, which manifests itself with severe pain in the lumbar region. The disease develops as a result of metabolic disorders, which leads to inadequate nutrition of cartilage and bone tissue, and waste products accumulate in bone cells. This leads to pathologies of the intervertebral discs. In addition, their thickness and flexibility change, and then growths in the form of osteophytes form on the vertebrae (growth of bone tissue, which leads to narrowing of the openings for nerve endings).
Reasons for the development of osteochondrosis of the lumbar spine
Osteochondrosis of the lumbar region is much more common than osteochondrosis of the thoracic or cervical spine, as the lower back has the greatest load during walking and running, prolonged sitting in a chair or lifting weights.
As this anatomical place takes the maximum load, its structure is very strong and reliable. The lumbar region consists of five vertebrae and connects the chest to the sacrum. Between them are the intervertebral discs, which give the spine flexibility and mobility. In turn, the intervertebral discs consist of a jelly-like nucleus, which is located inside a hard fibrous ring. When osteochondrosis develops, the normal nutrition of the discs is disrupted, as a result of which they become thinner, lose elasticity and the distance between them decreases. As a result, nerve roots are damaged, leading to severe pain and even disability.
Thus, the reasons for the development of this pathology are:
- spinal cord injury;
- diseases of the endocrine, digestive and cardiovascular systems;
- intense physical activity (weightlifting, jogging);
- sedentary way of life;
- malfunctions in the hormonal system;
- flat steps;
- anomalies of the intervertebral discs;
- old age;
- inflammatory diseases of the joints, such as rheumatoid arthritis.
Risk factors for the development of the disease are:
- stooping and poor posture;
- wrong way of life;
- unhealthy diet, obesity;
- long time in the wrong position;
- hereditary factor;
- stress;
- hypothermia.
The main symptom of the disease is pain in the lower back. It can be felt immediately or after intense physical activity.
Other symptoms of lumbar osteochondrosis are:
- painful pain radiating to the lower back;
- increased pain after lifting weights, sneezing, coughing, body movements;
- stiffness in the body after a long time in one position;
- constant spasms of the back muscles;
- sudden painful sensation (lumbago) after hypothermia of the body;
- impaired sensitivity of the buttocks, thighs, lower legs and feet;
- paresis of the legs;
- cold feet;
- spasm of the arteries of the legs;
- excessive sweating;
- dryness and flaking of the skin at the sites of pain.
Osteochondrosis of the lumbar spine can be aggravated by any awkward movement, such as moving or turning the body sideways. In this case, the pain is noticeable not only in the lower back but also in the legs. There is also a strong spasm of lumbar spasm, as in this way the body relieves the load on this part of the body. During exacerbations, a person finds a comfortable position for himself in which the pain subsides.
One of the complications of osteochondrosis of the lumbar spine is a malfunction of the genitourinary system. Occasionally there is increased urination and discomfort in the kidneys. Inflammation of the sciatic nerve and lumbodia (pain in the lower back) may join the disease.
Stages of osteochondrosis of the lumbar spine
Unfortunately, osteochondrosis is an incurable disease and the process of destruction of the intervertebral discs is irreversible. There are four stages of osteochondrosis:
- The first stage in which the jelly-like nucleus inside the disc changes and moves.
- The second stage is the period of destruction of the fibrous ring in the disc;
- Third degree, in which the fibrous ring ruptures and the jelly-like nucleus leaves it, causing the formation of a disc herniation.
- The fourth degree is the period of development of degenerative processes of the vertebrae with the participation of the intervertebral joints and ligaments. Osteoarthritis of the intervertebral joints (spondyloarthritis) develops.
First degree
It is characterized by painful sensations due to irritation of the nerve endings located in the fibrous ring and longitudinal ligaments. The patient feels pain and discomfort in the area of the affected disc. The pain can be sharp, sharp or dull, constant and localized in the lumbosacral segment. It is very often felt on the legs, and sometimes it is felt only in the legs.
Irritation of nerve endings leads to the development of reflex syndromes. For this reason, one does not always feel pain in the problem area, but far beyond it. Also, there is a violation of the robots of the internal organs, the appearance of reflex muscle spasm; circulatory disorders in the limbs and ligaments. Impaired blood circulation and nutrition of tendons and ligaments, leading to pain and hardening at the sites of attachment to the bones.
Second degree
At this stage, there is a characteristic instability and increased mobility of the vertebrae, which leads to constant lubrication of the muscles. At the same time, it is difficult for a person to stand, he feels discomfort and pain in the lower back. Sometimes the cross "hurts" and the patient does not understand why.
Third degree
It is characterized by prolapse of disc fragments, which is manifested by compression of nerve roots. During this period there is a violation of sensitivity in the area of innervation of the compressed nerve. In addition, there are unpleasant sensations in the form of tingling, burning, tingling, and complete loss of sensitivity, which is accompanied by impaired motor function, sometimes leading to paralysis. Muscle atrophy, thinning and shrinkage are observed in the affected area. The areas where the changes described above are observed eloquently show the location of the spinal cord injury. A characteristic manifestation of the third degree is the appearance of the Lasegue symptom. It manifests itself as follows: when the patient lies on his back, leg straight up, there is severe pain in the lumbar region, which spreads to the back of the raised leg. When the legs are bent at the knees, the pain immediately subsides.
When fragments of intervertebral discs fall into the lumen of the spinal canal, damage to the spinal cord occurs. Another syndrome, the so-called ponytail, is manifested by impaired sensitivity and motor function of the legs, as well as the pelvic organs and bladder.
Fourth degree
This period is characterized by the disappearance of pain and restoration of musculoskeletal function. However, at the same time there is a limitation of motor function. The spine seems to become wooden as disc fibrosis develops and all its elements are replaced by dense scar tissue. At the same time, the intervertebral ligaments and joints are involved in the inflammatory process, and various degrees of the disease are observed, which are manifested by polymorphism of the symptoms.
How to treat osteochondrosis of the lumbar spine
The treatment of osteochondrosis of the lumbar spine is a very long and persistent process. And most importantly, for the successful treatment of the disease much depends on the person himself. Eventually, he will have to radically change his lifestyle and get rid of many daily habits, as well as work on his health for the rest of his life.
Otherwise, even successful medical treatment will not be able to completely eliminate the deformity of the spine. In addition, after a temporary improvement, the symptoms will return with new intensity and treatment will have to start again. Although sometimes, even when following a regime of physical activity, attacks of osteochondrosis occur.
Thus, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug treatment;
- non-medicinal;
- surgery.
Conservative drug treatment
Because osteochondrosis of the spine cannot be completely cured and is an irreversible process, the goal of conservative treatment is to eliminate the symptoms and prevent further progression of the disease. Before starting medical treatment it is necessary to minimize physical activity. In severe exacerbations, bed rest is recommended. This is sometimes more effective than medication.
To relieve the symptoms of inflammation, use:
- NSAIDs (non-steroidal anti-inflammatory drugs). Drugs from this group effectively eliminate pain and inflammation in the vertebrae. Medicines can be in pills or injections.
- Glucocorticosteroids. These drugs are classified as steroid hormones. Glucocorticosteroid injections are given directly into the joint cavity. They are definitely enriched with B vitamins (B1, B6, B12).
- Soothing. They are needed to eliminate reflexogenic and related psychogenic disorders.
- Anticonvulsants. Eliminate involuntary skeletal muscle contractions.
- Antidepressants. Drugs in this group affect the level of neurotransmitters, as a result of which the patient's mood improves, melancholy, anxiety and emotional stress disappear.
- Diuretics. They are needed for signs of radicular syndrome.
- Anticholinesterase drugs. Drugs in this group inhibit the activity of the enzyme cholinesterase, resulting in increased conduction of nerve impulses.
- Chondroprotectors. Needed to prevent deformation of the spinal discs and joints.
In an acute attack, novocaine blockade is prescribed (introduction of anesthetic drugs directly into the affected area).
The symptoms of lumbar osteochondrosis in women are different than in men. In women, the menstrual cycle may be disrupted, as well as the development of gynecological diseases: inflammation of the ovaries and uterus (endometritis). Reproductive damage may also occur. In this case, you need the help of a qualified gynecologist.
How to treat lumbar osteochondrosis at home
The main principle of home treatment is the elimination of symptoms that prevent a person from living a quality lifestyle.
The following treatments are used at home:
- Diet. Very often the cause of osteochondrosis is the accumulation of cholesterol and loss of vascular elasticity. To correct the situation, it is necessary to adhere to a low-fat diet. Also exclude from the diet foods high in cholesterol: eggs, pork, rich broths, chicken skin. Eliminate alcohol and nicotine completely, reduce the consumption of coffee and strong tea. They lead to vasospasm.
- Restoration of blood supply in the lumbar region. To do this, use both rubbing with healing ointments and compresses, and physiotherapy exercises that can be performed at home.
- Orthopedic sleeping aids. Since the spine is the axis of the human body, which is subjected to great stress during the day, it needs proper rest. Orthopedic mattresses and pillows act in this capacity, which are able to give the spine the correct position during sleep.