Osteochondrosis of the lumbar spine - signs, diagnosis and treatment

Lumbar osteochondrosis is a common disease of the musculoskeletal system.The lumbar spine is most susceptible to injuries due to good mobility.Also, with irregular and prolonged seats in combination with a low -acting lifestyle, accelerated cartilage tissue wear, which ultimately leads to osteochondrosis.

You need to know how to recognize the first characters in order to receive timely qualified medical care.

Short information about osteochondrosis of the lumbosacral spine

Back pain is one of the most common complaints of patients with a traumatologist.The second name of the syndrome is the dorsalgia of the intervertebral discs.According to statistics, an average of 8 out of 10 people in their lives at least once complain of discomfort in the lumbar zone.Approximately one -third of patients who have seen the doctor, pain syndrome becomes a constant pathological nature, causing severe discomfort and painful condition in the patient.Long back pain can not only cause physical anguish, but also cause mental instability.

As cartilage tissue loses its strength and elasticity, it begins to gradually become sharper and collapse.As a result, cracks appear in the fibrous rings of the intervertebral discs.Over time, under pressure, the fibrous ring extends, protrudes and bursts.If the contents of the fibrous ring are an amvopic nucleus, it comes out, hernia is formed.For this reason, osteochondrosis increases the chances of such great complications.

The causes of the onset of the disease

In most cases, osteochondrosis is hereditary.It has been proven that if direct relatives suffer from degenerative diseases of the musculoskeletal system, then their children more often meet pathologies of the spine.

Other cases have extratebral reasons:

1. Maintaining an incorrect posture.
2. Excessive muscle surge, associated with high physical exertion at work or in sports.
3. Incorrect and frequent weight lifting.
4. One of the most common causes is hypodynamia.Lack of movement and minimal physical activity often leads to spinal problems than sports.
5. Early transmitted inflammatory infections - tuberculosis or osteomyelitis - contribute to the manifestation of degenerative processes in the spine.In this case, osteochondrosis will be infectious and will be a complication.
6. Hormonal perestroika can cause lumbosacral sacral osteochondrosis.This phenomenon is more commonly associated with certain age periods.The common example is to enter menopause.After the termination of the monthly cycles, the woman has a decline in sexual steroid hormones, which is why calcium practically ceases to be absorbed by the body.Bone reserves are washed intensively.As a result, if you do not put a woman in GZT, she will win not only osteochondrosis of the lower back, but also osteoporosis.The risk of osteochondrosis is increased with the frequent use of synthetic glucocorticosteroids.The risk increases during puberty with lack of nutrition, with exhausting physical activity in combination with a solid diet and when old age occurs.
7. The presence of congenital pathologies of the ridge, including an anomaly of tropism.
8. Flat legs and scoliosis.
9. The weak bone structure caused by nutritional deficiency or amenorrhea in women.
10. Premature wear of vertebrates and joints.
11. The premature hypermobility of the movable spine, which significantly increases the risk of injury.
12. Weak abdominal muscles.
13. The presence of rare pathologies, including a narrow spinal canal, peridural synthesis, spondylolist, oncology or tumor of the spine, neuromyositis.
14. The presence of endocrine disorders - obesity and uncompensated hypothyroidism.
15. Previously, they suffered injuries to the ridge, connections, joints, tendons.
16. Bad power and frequent psycho -emotional tensions.
17. Degenerative changes related to age.

There are also certain risk groups related to harmful professional activities.Examples are builders, wallets, computer scientists, waiters, teachers.To minimize the risk of such diseases, you must properly distribute the load on the back and get involved in moderately active physical activity.

Symptoms of lumbar osteochondrosis

The disease has many symptoms, so it is necessary to emphasize the classification according to the type of pain:

1. Ischemic syndromeassociated with compression of the arteries passing through the vertebrae.As a result of the occurrence, a constant deterioration of the blood circulation occurs, which is why nutrition is impaired in the lower limbs.It is possible to increase blood pressure.
2. Spine syndromeassociated with deformities that appear in nerves and vessels.With prolonged negative effects, changes in the posture, the back bends, the gait changes and the muscles without physical activity are atrophy.As a result, the patient begins to experience severe pain.
3. Static syndrome.Pathological mobility develops in the vertebrae that can occur kyphosis or lordosis.During the development of the pathology, the spine is gradually deformation, as in addition to the curvature in the vertebrae occurs incorrect fixation of the muscles in the affected areas.The consequences of static syndrome - the back is twisted and one is no longer able to straighten it alone.
4. Neurological syndromerelated to the pinching of nerve roots.If pressure occurs on the nerve endings, the patient's sensitivity decreases, weakness in the limbs may occur.In severe cases, paralysis, chills and complete loss of conductivity against the background of nerve fiber damage are noted.

The common symptoms of osteochondrosis of the lumbar spine include the following manifestations:

1. Strong lower back pain, including the entire lumbar region with a possible return to the sacrum.
2. With the development of radicular syndrome, there are acute pains that give bastards to the lower limbs.The legs usually capture cramps.There is numbness and paresthesia in the fingers.Rainly, the pain gives his hands.
3. Renal pain is possible.The patient may complain of urinary system problems that are not confirmed during the diagnosis.
4. The patient is tormented by poor sleep due to discomfort in the lumbar region.
5. The patient experiences tension and fatigue in the lumbar region.
6. When you turn your back and inclination, you feel stiffness and tension.
7. The legs are found at the back periodically.
8. After minor physical activity, the patient experiences severe fatigue.There is also chronic fatigue in everyday life.
9. With more progression of the disease, the patient has pain at rest in the lumbar region.
10. The limbs often tingle, and the patient often has a pathological crunch at the back.
11. Disruption of motor function due to lower back discomfort.
12. Muscle cramps and cramps.
13. Dizziness and headache.
14. Reducing the tone of the muscles of the hind and lower limbs.

All such symptoms require an appeal to the doctor.There are also specific gender -related signs.Men have problems in the genital sphere, which can negatively affect potency.Women have severe pain in the perineum and pelvis, which also indicates damage to the nerve endings.In advanced cases, a prolapse of the internal organs, including the uterus and appendages, occurs.This is due to strong atrophic processes in the muscles that support the spine.

Varieties of syndromes and symptoms of osteochondrosis of the lumbar spine

By the type and nature of the pain, such pathological conditions share:

1. Lumbago- It is characterized by acute condition.Characteristic signs are the inability to move from the pain that occurs against the background of the bastards.This condition is more likely to develop against the background of muscle atrophy, injuries, pinching of nerve roots and intervertebral discs.
2. Lumbalgia- Pathology characterized by long and sick pain.More often, lumbalgia occurs against the background of osteochondrosis, hernia, spondylosis or convexity.The syndrome is more common when stretching the ligament apparatus.
3. Sciatica.This type of pain syndrome is characteristic of the lumbosacral zone.The syndrome is often confused with needles, which is characterized by the launch of pain caused by the pinching of nerve roots.The pain syndrome is more commonly associated with the pinching of the sciatic nerve, which significantly impairs mobility in the lumbar region.The patient may not bend normally as the mobility of the lumbar region worsens.It is also difficult to walk and sit normally.The pressure of the sciatic nerve leads to another unpleasant worsening - spasm of the pear muscle.As a result, a person has shots from the back to the calf muscles passing through the thigh.The gait becomes lame, the socks of the legs are turned aside, and in your ass you experience pain when walking, running and sitting.A comprehensive approach to treatment is needed.
4. Discogenic changesrelated to the progression of dorsopathy.The first sign of such worsening is the loss of sensitivity and numbness in the lower limbs.The back, buttocks, hips and lower abdomen suffer.All of these areas are permeated with constant discomfort.With severe deterioration there are signs of an inflammatory process - fever, weakness occurs in the body, urinary incontinence occurs.The patient also impairs appetite, leading to a reduction in body weight.In this situation, an integrated approach is needed in the treatment of the condition.
5. RadiculopathyIt is also associated with limiting the motor skill of the spine and tightening of nerve endings.As a result of this type of pain syndrome, the patient begins to experience pain in the lower body, reducing or impaired motor reflexes.There is a deterioration in joint mobility and a decrease in muscle tone against the background of compression due to radiculitis.

All of the above pain syndromes require emergency treatment, starting from the initial stages of manifestations.In fact, over time, the pathology deteriorates, which is why the course of the disease leads to severe deterioration in quality of life.

Lumbar spine osteochondrosis - stages of development

The general classification of the disease in stages includes such degrees of development of osteochondrosis of the lumbar:

1. The first degree does not cause physiological deterioration from the spine.The patient is feeling well and does not suspect the presence of spinal problems.At the initial stage, active destructive processes occur.The pulpus nucleus changes its position, gradually penetrating through the microfins of the fibrous ring.Earlier in the article, it was mentioned that before the onset of the disease, the patient has a violation of the metabolic processes, which is why the cartilage sheath weakens and is covered with micro -cracks.As a result, irritation of the nerve endings occurs over time, which is why the patient may feel the first signs of discomfort in the lumbar region.
2. The second stage osteochondrosis is characterized by the appearance of signs of instability of the lumbar region.There are dynamic displacements in the vertebrae, compared to the above and main section.The patient has signs of compression syndrome and reflex disorders.
3. In the patient, in the case of 3, at the stage of the pathology, a deterioration occurs associated with the protrusion of the contents of the fibrous ring outwards.Prolapse or hernias are supposed.In the case of the 3rd stage of the pathology, the roots of the spinal canal and the blood vessels are pressed.At this stage, severe pain and inflammation are already occurring.Strong mobility is also limited, shelters arise in the lower limbs.
4. The terminal stage is the fourth.At this stage, irreparable pathophysiological changes are already occurring.The patient has pathologies of the bone system associated with the growth of bone bone bodies.As a result, compensatory reactions arise - the load is transferred to other, greater vertebrates.Stock, limiting mobility in the amplitude of the spine.Pathological growths of the bones press the vascular canal and the endings of the nerves, which significantly stresses the symptomatic course of the pathology.

Lumbar osteochondrosis - diagnosis

When the patient reaches the doctor, he prescribes a number of laboratory examinations based on the collected history to identify osteochondrosis of the lumbar spine sacrum:

1. X -ray.This is a basic analysis that allows you to evaluate the condition of the spine in general.X -ray will not show small and initial pathological changes, but will identify gross disorders in bone tissue.If the picture shows signs of erasure of vertebrates or darkening that do not match normal size, other studies are required.
2. Computed tomography.This is a more sophisticated version of the X -ray picture, which allows you to see the smallest negative changes in bone tissue at the site of destruction, as the photos are taken in a three -dimensional image.
3. Magnetic resonance imaging.This type of diagnosis is close to CT, but allows you to better consider soft tissues.MRI distinguishes the deterioration of osteochondrosis, including hernia and convexity.This type of diagnosis is sufficient to make an accurate diagnosis associated with degenerative destruction of bone tissue.
4. Laboratory testsBased on biomaterial.Patients often undergo a common blood and urine test to control the basic indicators.These data allow you to superficially evaluate the patient's health.
5. Delivery of rheumatological samples.It is necessary to analyze in order to eliminate the rheumatoid nature of the pathology.

After checking and conducting the necessary tests, they make a final diagnosis.

Treatment of lumbar osteochondrosis

In the treatment of pathology, an integrated approach is required.In stages 1-2 uses conservative treatment with the use of medicines and physiotherapy during the recovery period.In the presence of 3 or 4 stages, if the patient has serious indicators of health deterioration, surgery is required.

Treatment of the drug of the pathological process

In the case of damage to the intervertebral discs occurring against the background of osteochondrosis of the lumbosacral department, the use of an extensive list of drugs is indicated.Some products serve as symptomatic therapy, others to maintain health.

What medicines do they prescribe:

1. Non -steroidal anti -inflammatory drugs, analgesics.These drugs greatly facilitate the patient's condition, especially in the acute period.Due to the pronounced effect of this type of drug, it is possible to quickly soothe the pain within 1-2 days.Usually patients are prescribed by the NSAIDs of the selective type of action, as they are less damaging the mucous membrane of the stomach.If the indifferent old NSAIDs cannot be used for more than 5 days, then new generation drugs can be drunk for 2-3 weeks without fear of the consequences for a healthy gastrointestinal tract.In the presence of gastritis or ulcers, it is better to be safe and use gastroprotectors, proton pump inhibitors.
2. Monsolelaxati- Medicines designed to eliminate painful muscle cramps.With osteochondrosis, an improper distribution of load on the muscle corset associated with the weakness of the spine occurs.As a result, some muscles are pressed while others are in the hypotonus.Muscle relaxation is prescribed to relieve painful spasm.The duration of treatment and the pilling regimen are selected by the attending physician.
3. Neurotropic vitamins.Such agents include biamine vitamins, thiamine, cyanocobalamin and pyridoxine.With combined use B1, B6 and B12 in large doses, an analgesic effect occurs.The components have a positive effect on the nerve endings, nourishing them.These vitamins are also involved in the construction of myelin shells covering the nerves.Such medicines are mainly prescribed for radicular syndrome when it is necessary to relieve the pain associated with a pinch of nerves.For 2-3 weeks, injection agents are used and then switched to oral forms of release.
4. Chondroprotectors.These drugs have cartilage protective properties.If there are clear signs of cartilage degeneration, long -course chondroprotectors should be prescribed.First, the injection agents are used for 2-3 months and then switched to tablets.The minimum course of use is six months with a break of several months.The current components in the composition are chondroitin sulfate and glucoseamine hydrochloride.Admission and dosage schemes are selected individually.
5. Calcium in combination with vitamin D3.These components serve to strengthen bone tissue.With age, due to bone wear, malnutrition and hormonal deficiency, the fragile bones increases.The main building material is calcium.Without it, it is impossible to get a strong bone corset.In order to absorb calcium preparations, it is necessary to take vitamin D3.In order to avoid cholecalciferol deficiency, it is necessary to visit the sun regularly in the summer and take additional vitamins in winter.
6. Complex polyvitamins.Studies are reported that the constant intake of vitamins in natural or synthetic form in physiological doses strengthens immunity during seasonal exacerbations of SARS, acute respiratory infections.People with diseases of the lumbosacral spine should carefully monitor their own health.
7. Anesthetics blockadeThey are performed with poorly chopped pain syndrome using NSAIDs.Intracecular injections of corticosteroids that refer to the blockades are also effective.Such agents help to soothe inflammation, which accelerates recovery in the acute period.The blockade should be performed by a highly qualified doctor with extensive experience in their use.It is advisable to carry out the blockade under the control of the ultrasound so that you do not enter other parts of the spine.Such treatments will help you quickly get rid of chronic pain.
8. Special ointments and gels.With the help of local agents, you can also successfully fight chronic pain syndrome with moderate and mild power.Different products are cooled or warmed, which usually allows the use of external medicines regularly.The use of medicines on the surface of the skin allows you to use them for a long time.Such drugs are practically not absorbed into systemic blood flow, so they do not cause side effects.It is important to pay attention to the condition of the skin after administration of the medicine.If there is a rash or itching, you should cancel the medicine.

Homeopathy or antispasmodic can also be prescribed.The medication diagram is determined by the doctor on an individual basis.

Conservative methods of treatment without medicine

During the recovery period, physiotherapy procedures should be used to help improve blood circulation and normalize the metabolic processes in the affected tissues.Active recovery methods are used exclusively after stopping acute pain.Supporting conservative treatment softens the chronic course of the disease, which prevents the attacks of exacerbation.

Active rehabilitation methods include:

1. Conducting physiotherapy physical education.With the development of lumbar osteochondrosis, special exercises are needed that improve blood flow, which levels posture and keeps the muscles in the tone.Initially, LFK must be carried out under the supervision of an instructor, including safety rules.The exercises are performed in a permanent position, sitting or lying down, depending on the particular complex of a specialist.If the patient has experience, he or she can conduct gymnastics at home.You should not ignore the useful part of the lesson - warm -up and hanger.After a good warm -up, the muscles are protected from tears and sprains.The last stage of performance accelerates the processes of muscle recovery.With regular exercise, the muscles become strong, which causes back pain weakens.
2. Massage- a way to relax the tense muscle tissue in contact conditions.A specialist with the help of hands improves blood flow to the muscles, allowing you to eliminate strong surge.Massages in combination with muscle relaxants are the most effective.These drugs eliminate spasm and spasticity.Additional stimulation with hands potentiates the effect of the drug.It is recommended that you visit the massage therapist several times a year in courses so that a stable effect occurs.
3. Manual therapy.Using this method of exposure, it is possible to cancel the muscles and not take into account the degree of their resistance.Unlike massage, this method is violent, albeit effective.With neglected lumbar osteochondrosis, it is dangerous to use manual treatment practices if the specialist is not experienced enough.Before contacting a manual therapist, you should familiarize yourself with the list of contraindications, including hypertension, heart disease and the presence of hernia in the lumbar region.
4. Physiotherapy procedures.With the help of physiotherapy, it is possible to improve the local blood flow to the affected area without affecting other areas of the back.The essence of physiotherapy is simple: they combine methods and medicines for the treatment of hardware.Examples are electrophoresis.Under the influence of a laser with a certain frequency, medicines are administered through the skin.More often, use B vitamins. The device allows you to enter the skin of the skin to medicines without creating a systemic effect on the body.Magnetotherapy and shock wave therapy are also associated with physiotherapy methods.The emitted frequencies accelerate the processes of regeneration in the joints and connections without causing side effects.

As part of complex treatment, acupuncture, survivotherapy or homeopathy may be prescribed.

When surgery is performed

Operations are needed in advanced cases where the patient is tormented by serious neurological syndromes that occur against the background of lumbar osteochondrosis.If the patient has a complication in the form of hernia, the limbs have begun to take away and the sensitivity of the intestine or bladder is impaired, it is urgent hospitalized.In this case, the operation is performed according to life indicators.

There are also relative indications for surgery.Examples are frequent limb numbness, constant discomfort in the back, which is not susceptible to conservative treatment, partial loss of sensitivity in the fingers.In this case, you can independently solve surgical treatment.

Lumbar osteochondrosis is a serious pathology that requires an integrated approach to therapy.Medicines and physiotherapy are prescribed in the initial stages.If the disease is progressing quickly, surgery may be required.