Pain in the back and lumbar region is one of the most common complaints in medicine.They are in second place in the number of all requests, right after respiratory diseases.A large number of pathologies can cause pain in the lower back, but very often it is caused by osteochondrosis of the lumbar region.How to treat such a disease, what symptoms and signs it has, will be discussed below.
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.However, today the symptom of old age is not exclusive;Osteochondrosis of the lumbar spine is diagnosed in patients of different age groups.Today, the cut-off age is more than 25 years.
Causes of lumbar osteochondrosis
It is impossible to state the exact reason;it will almost always be a complex influence of various destructive factors, among which the most important can be singled out:
- Commitment to a passive lifestylefrom the point of view of motor activity.By their own will, immobilized people, for example, spend many hours at the computer, do not receive enough useful load, due to which the muscles of the "corset" relax and the load on the vertebrae increases.In addition, such entertainment is almost always associated with prolonged exposure to irregular 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 the increased load on the spinal column, for example, in patients with flat feet, curvature of the legs or spine.
- Chronic increased loadson the lower back.The risks here include people with certain types of occupational activities, which are usually associated with heavy lifting.This includes professional athletes who constantly expose their bodies to the greatest loads.
- Disturbed food intake and daily routine.This also includes regular exposure to stress.These factors affect metabolic processes and affect the periodic restoration of the body's strength.
The degree of osteochondrosis of the lumbar spine
The pathological factors listed above gradually lead to the manifestation of the disease.However, it can manifest in different ways, practically asymptomatic at the beginning or causing unbearable pain in late development.Let's consider the main stages of development of osteochondrosis:
- A situation in which the nucleus pulposus moves within the intervertebral disc.It is characterized by pain caused by irritation of the nerve roots of the fibrous ring and longitudinal ligaments.Discomfort is felt locally in the area where the defective disc is located.The pain can be either acute with 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, they become unstable in relation to each other.In order to eliminate these pathological manifestations, it is necessary to keep the muscles of this area constantly tense, which ultimately leads to chronic fatigue in the lower back.
- Then there is a breakthrough in the annulus fibrosus, which causes the nucleus to escape beyond the border of the disc, forming an intervertebral hernia.Such a case will be accompanied by pinching of the nerve endings, which is called "radicular syndrome".
- The next stage of osteochondrosis of the lumbosacral region occurs with serious deformation of the spine in this part.Mobility problems appear, but the pain syndrome, surprisingly, subsides at this stage.However, there is no need to rejoice;it does not mean that the disease dies.
- The last stage is characterized by pathological growth of bone tissue and general deterioration of health.
Based 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, pain sensations, the area of their localization and the direction in which they spread can vary.This happens due to the fact that, based on the degree of damage to the intervertebral disc and surrounding tissues, certain nerve receptors are irritated.In addition, the presence of a protrusion or the hernia itself, the direction of its protrusion and many other factors play a role.
The main symptoms of osteochondrosis of the lumbar spine include:
- The presence of aching pain in the lower back, which tends to increase with a sudden movement or, conversely, a long stay without changing the position.The pain is reduced if you take a horizontal position.
- In addition, weakness in the area of the body below the abdomen, including the lower extremities, is likely, as well as a dulled tendon reflex in the legs.
- 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, they speak of scoliosis, lordosis is a situation of bending forward, and kyphosis is a case when the natural lumbar curve is, so to speak, smoothed out.
- At a serious stage of the development of the disease, it is possible to pinch the canal of the spinal cord, which can cause its dysfunction and lead to uncontrolled urination and stool.
Additional symptoms include:
- The presence of numbness and "coldness" of the skin of the lower back and buttocks.
- Flaky, dry and blue skin in the same places.
- Difficulty urinating.
- Erection problems.
The presence of these symptoms should alert a person;they should not be abandoned, it will only lead to greater neglect.In that case, you should definitely consult a doctor for an accurate diagnosis and treatment.Otherwise, treatment can be in a hospital setting or at home, but more on that later.
Disease diagnosis
When making a diagnosis, it is important to understand the extent to which the disease has progressed.The easiest way is palpation in the lumbar region to identify the area of pain.Usually, this method is not very informative, and in addition, examinations are carried out that give a more detailed clinical picture:
- Radiography, a cheap and widespread method, it is possible to assess the condition of both the spine as a whole and individual vertebrae, for example the lumbar region in question.The technique is not very accurate;it only allows us to indirectly understand how intact the intervertebral discs and spinal canals are.
- Computed tomographya more accurate method that allows you to assess the level of damage to the discs between the vertebrae, nerve roots and canals of the spinal cord.
- Magnetic resonancethe most accurate method, it gives a complete picture of the lesion in detail, but it is quite expensive and unavailable.
It should be noted that the diagnostic process is very important, because all the details of the developed osteochondrosis are important for the doctor when prescribing treatment tactics.
Complications of osteochondrosis
The main complications of the 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 spinal canal entrapment.
- Functional disorders in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When osteochondrosis of the lumbar spine is diagnosed, a wide range of therapy is required, the main aspects of which will be:
- Application of moderate loads.
- Special medicines.
- Traction of the spinal column.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of "treatment" of osteochondrosis implies:
- Suppression of inflammation.
- Alleviation of pain syndrome.
- Complex for strengthening the lumbar and adjacent muscle groups.
- Relief from chronic muscle tension.
- Increasing the functionality of organs in the pelvis.
- Normalization of blood circulation and metabolism in the pathological area.
Drug treatment
A similar approach to the treatment of lumbar osteochondrosis includes taking drugs, 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:
- Analgesics that have an analgesic effect.
- Anti-inflammatory drugs of non-steroidal origin.
- For muscle spasms, antispasmodics.
- Medicines for restoring cartilage tissue, called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in traditional medicine.
- For serious pathologies, when the above drugs do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these drugs, drugs in tablets are also prescribed, the purpose of which is to calm the nervous system and suppress 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 stimulation of the spine's regeneration process.A wide range of physiotherapeutic procedures are used for these purposes, the most popular of which are:
- Phonophoresis.
- Diadynamic current therapy.
- Laser therapy.
In addition, useful loads should be given to the spine while simultaneously stretching.Different types of therapeutic massages are ideal for this.It should be remembered that massage is used only when the pain is alleviated.As a rule, it is carried out as a restorative measure when the disease remission process has begun or in case of chronic osteochondrosis.After the massage, the muscles overloaded by the disease are well relaxed;its effect will be significantly enhanced when simultaneously heated, for example in a bath or sauna.In the latter case, we achieve the maximum effect thanks to the additional stimulation of blood circulation in the pathology zone and adjacent areas.
Another method of physical therapy is manual therapy.Its benefits are mostly the same as those of massage, but in addition, with the help of such techniques, the specialist can return the displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercises are also used as a restorative and preventive measure in the period when pain and inflammation have already been removed.The key to the high efficiency of therapeutic exercises is the regularity of the exercises;in this case, the damaged area will constantly receive the necessary physical activity for self-generation of new tissue and recovery.
Surgical operations of lumbar osteochondrosis
Surgical intervention is a last resort, which is prescribed for serious complications.The most common of them is intervertebral hernia, when the so-called "discectomy" or removal of the affected intervertebral disc is performed.Surgery is very effective, however, as a last resort, it is prescribed only if other methods of therapy have failed for more than 6 months.Modern medicine also offers less traumatic methods of performing such an operation, for example, microsurgical or endoscopic methods.