Lumbar osteochondrosis: causes, symptoms, diagnosis, treatment

Lumbar osteochondrosis is a dangerous disease of the spine, characteristic of people who have reached the age of 35 years and above. Natural consumption of joints causes the development of pathology. Premature access to a rheumatologist, in most cases, leads to disability. Modern medicine offers many effective methods of treatment in the initial stages. Early diagnosis is the key to a healthy, unrestricted life.

Lumbar osteochondrosis - general definition

Lumbar spine osteochondrosis is a dystrophic degeneration process in intervertebral cartilage formations - discs.

The discs offer the main functions of the spine - the ability to move and bend, resistance to stress. As a result of the pathology, important elements become thinner, deformed, the vertebrae are lined up, the nerve endings and blood vessels are constricted. Negative processes are associated with pain sensations of varying intensity and limitation of motor function.

The pathology causes changes in the connecting elements of the spine - cartilage, bones, discs and joints. It is caused by natural consumption processes, as well as by acquired joint diseases or by an improper lifestyle.

Causes

There can be many reasons for the development of lumbar osteochondrosis:

• Natural or premature body wear;
• Excessive load on the lower back - lifting loads, work "on foot" or a sedentary, "sedentary" lifestyle;
• Genetic predisposition to joint diseases, such as rheumatoid arthritis;
• Violation of metabolism, resulting in the accumulation of toxic substances in the connective discs;
• Chronic diseases of the circulatory system. Nutrients and trace elements cease to enter the cartilage tissue in the right amount. Hypoxia begins, which contributes to the destruction of intervertebral joints;
• Autoimmune pathologies.

Secondary factors may also provoke the development of lumbar osteochondrosis:

• Chronic injuries, bruising of the back;
• Exceeding the weight rate by more than 15-20%;
• Heavy or power sports;
• Constantly wearing uncomfortable shoes. High heels, tight shoes, rubber or sports shoes are the first enemies of the spine;
• Valgus changes in the foot;
• Scoliosis, kyphosis, diabetes mellitus, spinal tuberculosis;
• Impact of low temperatures.

Clinical appearance

The symptoms of lumbar osteochondrosis depend entirely on which nerve roots are affected by the disease. The degree of compression of the vertebrae, the stage of the disease and the damage to the disc determine the signs.

Rheumatologists distinguish the following main symptoms:

• Violation of tactile sensitivity in the lumbar region. The numbness extends to the inside of the thighs and hips. It can affect one or both limbs;
• There is a sharp pain, shooting in the lower back. The thumb completely loses mobility and characteristic numbness is observed;
• Loss of normal foot function, tenderness of the toes, lower leg and outer thigh. In these parts of the foot, there is a regular tone and convulsive seizures. On examination, there is no Achilles reflex;
• If the disease affects the lower radicular artery, then there is complete paralysis of the muscles of the buttocks, back of the thighs and perineum. There is a severe violation of motor function, up to complete immobility.

With lumbar osteochondrosis, not only the nerve endings of the spine are affected, but also the blood vessels.

The following specific signs depend on the type of lesion:

• When only the nerve roots are disturbed, a change in the patient's gait is observed. The pain is localized not only in the lumbar area, but also in all parts of the legs. Radicular syndrome is characterized by persistent pain. Usually only on one side. There is a tingling sensation and pain in the lower back. The pain can be relieved with a little exercise.
• Compression of blood vessels leads to perfusion in the groin area. As a result, oxygen starvation of the spinal discs occurs. Painful sensations appear when walking on the buttocks, thighs and lower back. Completely removed after a night's break.

Simultaneous violation of the functionality of blood vessels and nerve roots can lead to irreversible deformation of the discs. In the movable joints of the lower back thorn-shaped bone protrusions are formed. This leads to severe pain and makes normal natural movement impossible. Violated posture, walking. As it progresses, complete paralysis may occur.

Stages of the disease

Lumbar osteochondrosis develops gradually, in several stages. Each stage has its own characteristics, which determine the degree of progress.

• I scan.Slow destruction of intervertebral discs begins. The process can take from several months to 2-5 years. Manifested by minor pain, discomfort in the inguinal and femoral muscles. It is noticed when you walk or when the weather changes.
• Phase II.The collagen fibers of the fibrous rings of the spine are pulled in the negative process. The space between the individual vertebrae is shrinking rapidly. Friction appears, which causes severe pain attacks. Violated gait, posture, bending appear. Lumbar osteochondrosis is most often diagnosed in the second stage of the course.
• Phase III.An intervertebral hernia appears. And if the patient was not forced to seek medical help with stage II symptoms, then it will no longer be possible to ignore the torturous pain of stage three. The deformation of the bones and joints of the spine in the lumbar area is already irreversible. Walking requires a lot of effort. This is due to the pain and inability to relieve it with ordinary sedatives.
• Phase IV.Partial or complete impairment of motor function. At this stage, the patient is assigned a disability group. Threatened with complete paralysis. Vital activity is impossible without taking a wide range of medicines.

Diagnostic measures

Diagnostic measures include several techniques and begin with the collection of a complete history of the disease. During the initial consultation with the rheumatologist, the following data are clarified:

1. The patient's complaints are carefully analyzed - the place of localization of pain, where there is still discomfort, in which parts of the thigh joint there is a feeling of heaviness, convulsions, etc. ;
2. Duration, regularity, nature of pain;
3. When the first symptoms, even minor ones, appeared. How much time has passed since the last attack, what causes concern and what factors contribute to its elimination;
4. Surrounding conditions of the patient's living. Occupation, work, home workload, sports and the presence of additional factors for increasing physical activity (dacha, garden, hobbies related to weight transfer);
5. Examination of the history of diseases that the patient has suffered in the past or present.

After collecting the clinical picture, the rheumatologist proceeds directly to the external examination. During the examination, the gait, the anatomical position of the legs, arms, torso, in relation to the spine are analyzed. The skin is examined for changes - pigmentation, skin, eczema, redness, etc. An assessment of motor function is given.

Performing simple exercises - leaning forward, backward, raising the arms and legs, turning the head, rotational movements of the pelvis, the patient allows the doctor to determine the degree of spinal cord injury in the lumbar region.

The final measures of external examination are the actions to determine the degree of radicular damage:

• Lasegue symptoms.Lying on his back, the patient raises his legs alternately, bent at the knee. If this causes pain in the lower back, then the readings are considered positive.
• Dejerine Symptoms.The patient is asked to tighten the abdominal muscles as much as possible. The appearance of discomfort in the spine indicates the development of lumbar osteochondrosis.
• Neri Symptoms. Sharp inclinations of the head forward and backward respond with pain in the lower back.
• Wasserman Symptoms. The patient, in the supine position, moves the leg as far to the side as possible. In the presence of pathology, uncomfortable pain appears in the groin and front of the thigh.

To confirm or rule out the diagnosis, the patient is invited to undergo instrumental diagnosis. MRI is considered the most effective way to determine lumbar osteochondrosis. The study shows the distance between the vertebrae, the development of neoplasms and bone deformities. May be contraindicated in patients with mental disorders.
Computed tomography gives a fairly true picture of the disease in a plane - horizontal or vertical.
X-rays are used only in the final stages, when irreversible changes begin in the bone tissue of the spine.

Complex treatment of lumbar osteochondrosis

The causes of the pathology have not been fully elucidated. Research in the field of articular diseases of the spine has not yet identified quite effective methods for complete restoration of intervertebral discs. Modern methods of treatment are aimed only at eliminating the external signs of the disease. Full recovery is currently considered impossible.

Traditional drug therapy

The rheumatologist prescribes medication, depending on the general condition of the patient. The clinical picture provides the information needed to design a treatment regimen from several groups.

1. Anesthetic agents.Injections, ointments or broad-spectrum medicines are prescribed.
2. Anti-inflammatory drugs (NSAIDs).
3. Vasodilators.Removal of tone from the muscles of the waist and legs.
4. Chondroprotectors.Designed to rule out negative progression of lumbar osteochondrosis.

Physiotherapy

Physiotherapy procedures are an integral part of the inpatient or outpatient treatment of lumbar osteochondrosis.

Includes the following activities:

• Soothing electrophoresis;
• Magnetotherapy;
• Hydrotherapy;
• Paraffin applications.

Medication and physiotherapy in the complex relieve acute pain and inflammation. But they are no guarantee of stopping the progression of the pathology. Only a course of treatment 2-3 times a year and a responsible attitude of the patient will help to avoid regression and maintain the general condition in a satisfactory form.

Exercise therapy and therapeutic massage

A set of therapeutic gymnastics exercises ensures the normalization of blood circulation in the lower back and helps eliminate stagnant processes. Only a physiotherapist can prescribe exercises for clinical or home use. As a rule, these are all kinds of gentle inclines and rotational movements, from an inclined and sitting position. Independent physical activity not only can bring no results, but cause even more displacement of the vertebral discs.

Manual therapy sessions help strengthen muscle tissue, lower blood flow to the affected back, and relieve tension. The specialist first massages a healthy part of the back, to warm up the muscles and improve blood circulation. Then it goes to the affected lumbar areas. The area of manipulation includes the lower back, buttocks, thighs, legs and feet. Sessions are held in regular courses, at least 10 sessions in 6 months.

Surgical intervention

Indicated in the last stage of lumbar osteochondrosis, to restore motor function of the spine. Surgery remains the only option for patients who present with the following symptoms:

• Persistent pain syndrome, unacceptable for treatment even with opiate-containing drugs;
• Strong compression of the nerve roots and considerable displacement of the discs;
• Neoplasms, proliferation of bone tissue;
• Complete destruction of the vertebrae, due to constant friction;
• Paralysis.

Modern methods offer less traumatic methods of internal intervention. For example, endoscopy. Has a favorable prognosis, a short rehabilitation period and a low rate of side effects.

Alternative treatment

Lumbar osteochondrosis responds well to treatment with medicinal herbs and folk methods. Ointments, tinctures, baths on a tariff basis are used to relieve swelling and pain. The most effective recipes include anesthetic and anti-inflammatory herbs:

• yarrow;
• Aloe;
• Mint;
• St. John's wort;
• spruce or pine needles;
• Sherebela.

The content of these herbs in folk recipes is due to their medicinal effects, scientifically proven by traditional medicine. Home treatment will help maintain the lower back in a stable condition and prevent disease exacerbation after complex treatment.

prevention

Despite the fact that lumbar osteochondrosis is an incurable disease, its negative manifestations can be minimized. In the early stages, the disease is successfully treated, it is only necessary to seek medical help in a timely manner. It is important to fully adhere to the designed treatment regimen and follow the rheumatologist's recommendations.