Back and lumbar pain are among the most common complaints in medicine.They rank second in number of all inquiries, just behind respiratory diseases.A variety of pathologies can cause pain in the lower back, but very often they are caused by osteochondrosis of the lumbar region.How such a disease is treated, what symptoms and signs it has, will be discussed below.
Not so long ago, medical science believed that osteochondrosis in the lumbosacral region was due exclusively to age-related changes that lead to wear and tear of the vertebrae and intervertebral discs.Nowadays, however, the symptom of aging is not exclusive;Osteochondrosis of the lumbar spine is diagnosed in patients of different age groups.The exclusion age is now considered to be over 25 years old.
Causes of lumbar osteochondrosis
It is impossible to pinpoint the exact reason;Almost always it will be the complex effect of various destructive factors, the main of which can be identified:
- Commitment to a passive lifestylefrom the point of view of motor activity.Immobilized people who, for example, spend many hours at the computer, do not receive enough payload of their own free will, which is why the “corset” muscles relax and the load on the vertebrae increases.In addition, such a pastime is almost always associated with prolonged exposure to incorrect and unnatural positions.
- Problems with hormone levels, which leads to metabolic disorders that affect the metabolism of spinal tissue in the lumbar region and contribute to destructive processes.These also include diseases of an endocrine nature.
- Presence of congenital or acquired anomalieswhen the musculoskeletal system undergoes certain changes.This can manifest itself in increased load on the spine, for example, in a patient with flat feet, curvature of the legs or spine.
- Chronic increased stresson the lower back.The risks here include people with certain professional activities that usually involve lifting heavy loads.This also includes professional athletes who constantly subject their bodies to peak stress.
- Disturbed food intake and daily routine.This also includes regular exposure to stress.These factors affect metabolic processes and affect the regular restoration of the body's strength.
Degrees 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, being virtually asymptomatic at the beginning or causing barely tolerable pain in late development.Let's consider the main stages of development of osteochondrosis:
- A situation in which the nucleus pulposus moves within the disc.It is characterized by pain caused by irritation of the nerve roots of the fibrous ring and longitudinal ligaments.Local complaints occur in the area of the defective intervertebral disc.The pain can be either acute with stabbing or persistently dull.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the elements of the spine in this area increases, they become unstable relative to each other.To eliminate these pathological phenomena, it is necessary to constantly keep the muscles of this area tense, which ultimately leads to chronic fatigue in the lower back.
- Next, there is a breakthrough in the fibrous ring, which causes the nucleus to protrude beyond the edge of the disc and creates an intervertebral hernia.In such a case, the nerve endings become trapped, which is called “radicular syndrome”.
- The next degree of osteochondrosis of the lumbosacral region occurs with a severe deformation of the spine in this part.Mobility problems arise, but, strangely enough, the pain syndrome subsides at this stage.However, you shouldn't rejoice;This does not mean that the disease is going away.
- The last degree is characterized by pathological growth of bone tissue and a general deterioration in health.
Depending 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 of their spread may vary.This happens because, depending on the degree of damage to the intervertebral disc and the surrounding tissue, certain nerve receptors are stimulated.In addition, the presence of a bulge or hernia itself, the direction of its bulge 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 increases during sudden movements or, conversely, when remaining for a long time without changing position.The pain subsides when you assume a horizontal position.
- In addition, weakness in the body area below the abdomen, including the lower extremities, as well as a weakened tendon reflex in the legs can be expected.
- There is a high probability of curvature of the lumbar spine.There is a classification of such curvatures, for example if the emphasis is on the right or left side, it is called scoliosis, lordosis is the situation of forward bending and kyphosis is a natural lumbar curvature that has been smoothed to a certain extent.
- If the course of the disease is severe, pinching of the spinal canals is possible, which can lead to dysfunction and uncontrolled urination and bowel movements.
Other symptoms include:
- The presence of numbness and “coldness” of the skin of the lower back and buttocks.
- Scaly, dry and blue skin in the same places.
- Impaired urination.
- Erection problems.
The presence of these symptoms should alert a person;You shouldn't give them up, that 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 take place either in the hospital or at home, but more on that later.
Diagnosis of the disease
When making a diagnosis, it is important to understand how advanced the disease is.The easiest way is to palpate the lumbar region to identify areas of pain.Typically, this method is not very informative and additional examinations are carried out that provide a more detailed picture of the disease:
- By X-rayThis inexpensive and widely used method makes it possible to assess the condition of both the entire spine and individual vertebrae, for example the lumbar spine in question.The technique is not very precise;It only allows us indirectly to understand how intact the intervertebral discs and spinal canals are.
- Computed tomographyA more accurate method that allows you to assess the degree of damage to the intervertebral discs between the vertebrae, nerve roots and canals with the spinal cord.
- Magnetic resonance imagingThe most accurate method provides a complete picture of the lesion 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 treatment tactics.
Complications of osteochondrosis
The main complications of pathology are hernias and protrusions, which inevitably occur if treatment is neglected and the development of the disease is left to chance.Further complications can include:
- Inflammation of the sciatic nerve.
- Spondyloarthrosis.
- Schmorl hernia.
- Spondylosis.
- Problems caused by pinched spinal canals.
- Dysfunction in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When diagnosing osteochondrosis of the lumbar spine, a wide range of therapy is required, the main aspects of which will be:
- Application of moderate loads.
- Special medications.
- Spinal traction.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of “treatment” of osteochondrosis implies:
- Suppression of inflammation.
- Relief of pain syndrome.
- Complex to strengthen the lumbar spine and adjacent muscle groups.
- Relief of chronic muscle tension.
- Increasing the functionality of the organs in the pelvis.
- Normalization of blood circulation and metabolism in the pathological area.
Treatment with medication
A similar approach to the treatment of lumbar osteochondrosis includes taking medications, injections of special drugs, and using ointments and gels for external use.The main task of such drugs is to neutralize pain and inflammation.
Depending on the degree of osteochondrosis of the spine in the lumbar region, the doctor may prescribe the following medications:
- Analgesics with pain-relieving effects.
- Anti-inflammatory drugs of non-steroidal origin.
- For muscle cramps, antispasmodics.
- Medicines to restore cartilage tissue, so-called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in conventional medicine.
- In serious illnesses, when the above remedies do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these medications, medications are prescribed in tablet form, the purpose of which is to calm the nervous system and combat stress and depression.
Physiotherapeutic treatment of lumbar osteochondrosis
The treatment process is rarely limited to taking pills.The pathology in question cannot be cured without stimulating the recovery processes of the spine.For this purpose, a wide range of physiotherapy procedures are used, the most popular of which are:
- Phonophoresis.
- Therapy with diadynamic currents.
- Laser therapy.
In addition, the spine must be properly loaded and stretched at the same time.Various forms of therapeutic massage are suitable for this.It must be remembered that massage is used only when pain is relieved.As a rule, it is carried out as a restorative measure when the remission process of the disease has begun or in chronic osteochondrosis.After a massage, muscles that are overstressed due to illness are relaxed well;Its effect is significantly increased when heated at the same time, for example in a bathhouse or sauna.In the latter case, we achieve maximum effect by additionally stimulating blood circulation in the pathology zone and adjacent areas.
Another method of physiotherapy is manual therapy.The benefits are generally the same as massage, but with the help of such techniques, a specialist is also able to return displaced vertebrae to their normal position.
Therapeutic gymnastics
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 lies in the regularity of the exercises;In this case, the damaged area constantly receives the necessary physical activity for the self-formation of new tissue and recovery.
Surgical interventions for lumbar osteochondrosis
Surgery is the last resort prescribed in case of serious complications.The most common is a herniated disc, in which a so-called “discectomy” or removal of the affected disc is carried out.The operation is very effective, but is only prescribed as a last resort 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.