Back and lumbar pain is one of the most common complaints in medicine.They are in second place in terms of the number of all requests, second only to respiratory diseases.A wide variety of pathologies can cause pain in the lower back, but most often it is caused by osteochondrosis of the lumbar region.How to deal with 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 age is not exclusive.Osteochondrosis of the lumbar spine is diagnosed in patients of various age groups.Today, the cut-off age is considered to be over 25 years.
Causes of lumbar osteochondrosis
It is impossible to name the exact cause.It will almost always be the complex impact of various destructive factors, among which the most important can be identified:
- Commitment to a passive lifestylein terms of motor activity.By their own will, immobilized people, for example, spending many hours at a computer, do not receive enough useful load, because of this the muscles of the "corset" relax and the load on the vertebrae increases.In addition, such a hobby is almost always associated with prolonged exposure to incorrect and unnatural postures.
- Problems with hormone levels, leading to metabolic disorders, which affect the metabolism of spinal tissue in the lumbar region and contribute to destructive processes.This also includes diseases of an endocrine nature.
- Presence of congenital or acquired abnormalitieswhen the musculoskeletal system undergoes certain changes.This may be reflected in increased loads on the spine, for example, in a patient with flat feet, curvature of the legs or spine.
- Chronically increased loadsin the lower back.Here, the risks include people with certain types of occupational activities, usually associated with heavy lifting.This also includes professional athletes who constantly subject their bodies to peak 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.
Grades of osteochondrosis of the lumbar spine
The above pathological factors gradually lead to the manifestation of the disease.However, it can manifest itself in different ways, practically asymptomatic at the beginning or causing unbearable pain during late development.Let's consider the main degrees of development of osteochondrosis:
- A condition in which the nucleus pulposus moves within the intervertebral disc.It is characterized by pain caused by irritation of the nerve roots of the annulus fibrosus and longitudinal ligaments.Discomfort is felt locally in the area where the defective disc is located.The pain can be either sharp with shooting or a constant dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the spinal elements in this area increases, they become unstable among themselves.To eliminate these pathological manifestations, it is necessary to keep the muscles of this area constantly stretched, which ultimately leads to chronic fatigue in the lower back.
- Then, a breakthrough occurs in the annulus fibrosus, which causes the nucleus to escape beyond the confines of the disc, forming an intervertebral hernia.Such a case will be accompanied by pinching of the nerve endings, which is called "radial syndrome".
- The next degree of osteochondrosis of the lumbosacral region occurs with severe deformation of the spine in this part.Problems with mobility appear, but the pain syndrome, surprisingly, subsides at this stage.However, you should not rejoice.this does not mean that the disease disappears.
- The last degree 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, the sensations of pain, their location 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 a 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 pain in the lower back, which tends to intensify with sudden movement or, conversely, with staying without changing position for a long time.The pain subsides if you take a horizontal position.
- In addition, weakness in the area of the body below the abdomen, including the lower limbs, as well as a dull tendon reflex in the legs is possible.
- There is a high possibility 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 the state of bending forward, and kyphosis is the case when the natural lumbar curve is smoothed out.
- With a severe degree of development of the disease, pinching of the channels of the spinal cord is possible, which can cause its malfunction and lead to uncontrollable urination and feces.
Additional symptoms include:
- The presence of numbness and "coldness" of the skin of the back and buttocks.
- Flaky, dry and blue skin in the same places.
- Urination disorder.
- Erection problems.
The presence of these symptoms should alert a person.one should not give up, this will only lead to more neglect.In this case, you should definitely consult a doctor for an accurate diagnosis and treatment.By the way, treatment can be done either in a hospital setting or at home, but more on that a little later.
Diagnosis of the disease
When making a diagnosis, it is important to understand the extent to which the disease has progressed.The easiest way is to palpate the lumbar region to locate areas of pain.Usually, this method is not very informative, and in addition, tests are carried out that give a more detailed clinical picture:
- By x-ray, an inexpensive 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 precise.It only allows us to indirectly understand how intact the intervertebral discs and spinal canals are.
- CT scana more accurate method that allows you to assess the level of damage to the discs between the vertebrae, nerve roots and canals with the spinal cord.
- Magnetic resonance imagingthe most accurate method, gives a complete picture of the damage in detail, but is quite expensive and inaccessible.
It should be noted that the diagnostic process is very important, since all the details of the developed osteochondrosis are important for the doctor when prescribing therapeutic tactics.
Complications of osteochondrosis
The main complications of the pathology are hernias and protrusions, which inevitably appear if treatment is neglected and the progression of the disease is left to chance.Other complications may include:
- Inflammation of the sciatic nerve.
- Spondyloarthritis.
- Schmorl's hernia.
- Spondylosis.
- Problems caused by pinched spinal canals.
- Functional disorders in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When diagnosed with osteochondrosis of the lumbar spine, a wide range of treatment is required, the main aspects of which will be:
- Application of moderate loads.
- Special medicines.
- Traction of the spine.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of "treatment" for osteochondrosis implies:
- Suppression of inflammation.
- Relief of pain syndrome.
- Complex for strengthening the lumbar and adjacent muscle group.
- Relief from chronic muscle tension.
- Increasing the functionality of the 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 the restoration of cartilage tissue, called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in traditional medicine.
- For severe pathologies, when the above treatments do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these drugs, drugs are prescribed in tablets, the purpose of which is to calm the nervous system and fight stress and depression.
Physiotherapy treatment for lumbar osteochondrosis
The treatment process is rarely limited to just taking pills.This pathology cannot be cured without the stimulation of the spine's restoration processes.For these purposes, a wide range of physiotherapy procedures are used, the most popular of which are:
- Voicing.
- Treatment with alternating currents.
- Laser treatment.
In addition, the spine must accept useful loads while at the same time stretching it.Various types of therapeutic massage are ideal for this.It must be remembered that massage is used only when the pain is relieved.As a rule, it is carried out as a restorative measure when the process of remission of the disease has begun or in chronic osteochondrosis.After a massage, the muscles strained by the disease are well relaxed.Its effect will be greatly enhanced when heated at the same time, for example in a bath or sauna.In the latter case, we will achieve the maximum effect due to additional stimulation of blood circulation in the zone of pathology and adjacent areas.
Another method of physical therapy is manual therapy.Its benefits are generally the same as those of massage, but in addition, with the help of such techniques, a specialist can return displaced vertebrae to their normal position.
Therapeutic exercise
Therapeutic exercises are also used as a restorative and preventive measure during the period when pain and inflammation have already been relieved.The key to the high effectiveness of therapeutic exercises is the regularity of the exercises.In this case, the damaged area will constantly receive the necessary physical activity for self-production of new tissue and recovery.
Surgery for lumbar osteochondrosis
Surgery is the last resort, which is prescribed for severe complications.The most common of these is intervertebral hernia, when a so-called "discectomy" or removal of the affected intervertebral disc is performed.The operation is very effective, however, as a measure of last resort, it is prescribed only if other methods of treatment have failed for more than 6 months.Modern medicine also offers less traumatic methods for performing such an operation, for example, microsurgical or endoscopic methods.