Osteochondrosis of the lumbar spine is a pathological change in the cartilage and bone tissue of the intervertebral discs in the lumbosacral spine. This change can be natural or the result of an unhealthy lifestyle. In old age, the involutive processes of bone and cartilage tissue begin in all people. But when these phenomena are premature (they appear in middle-aged people), then we are talking about pathological processes of the skeletal system. The pathology equally affects men and women over 30 years of age.
Lumbar osteochondrosis is the most famous and common disease of the spine, manifested by severe pain in the lumbar region. The disease develops as a result of metabolic disorders, which leads to improper nutrition of cartilage and bone tissue, and waste products accumulate in bone cells. This leads to pathologies of the intervertebral discs. In addition, their thickness and flexibility change, and then growths in the form of osteophytes (growth of bone tissue, leading to the narrowing of the holes for nerve endings) form on the vertebrae.
Reasons for the development of osteochondrosis of the lumbar spine.
Osteochondrosis of the lumbar area occurs much more often than osteochondrosis of the thoracic or cervical spine, due to the fact that the lower back has the greatest load when walking and running, when sitting for a long time in a chair or when lifting dumbbells.
Since this anatomical site supports the maximum load, its structure is very strong and reliable. The lumbar region consists of five vertebrae and connects the rib cage with the sacrum. Among them are the intervertebral discs, which give flexibility and mobility to the spine. In turn, the intervertebral discs consist of a gelatinous nucleus, which is located within a hard fibrous ring. When osteochondrosis develops, the normal nutrition of the discs is disrupted, as a result, they become thinner, lose elasticity, and the distance between them decreases. As a result, nerve roots are infringed, leading to severe pain and even disability.
Thus, the reasons for the development of this pathology are:
- spinal injury;
- diseases of the endocrine, digestive and cardiovascular systems;
- intense physical activity (lifting weights, running hard);
- sedentary lifestyle;
- malfunction of the hormonal system;
- flatfoot;
- abnormalities of the intervertebral discs;
- old age;
- inflammatory diseases of the joints, such as rheumatoid arthritis.
Risk factors for the development of the disease are:
- hunched over and poor posture;
- wrong lifestyle;
- unhealthy diet, obesity;
- being in the wrong posture for a long time;
- hereditary factor;
- stress;
- hypothermia.
The main symptom of the disease is low back pain. It can be felt immediately or after vigorous physical activity.
Other symptoms of lumbar osteochondrosis are:
- aching pain radiating to the lower back;
- increased pain after lifting weights, sneezing, coughing, moving the body;
- stiffness in the body after being in one position for a long time;
- persistent spasms of the back muscles;
- sudden feeling of pain (lumbago) after hypothermia of the body;
- violation of sensitivity in the buttocks, thigh, lower leg and foot;
- paresis in the legs;
- coldness of the feet;
- spasm of the arteries of the feet;
- excessive sweating;
- dryness and peeling of the skin in places of pain.
Osteochondrosis of the lumbar spine can be aggravated by any awkward movement, for example, when moving or turning the body to the side. In this case, the pain is noticeable not only in the lower back, but also in the legs. There is also a strong spasm of the lumbar spasm, as in this way the body relieves the load on this part of the body. During an exacerbation, a person finds a comfortable position for himself in which the pain subsides.
One of the complications of osteochondrosis of the lumbar spine is a malfunction of the genitourinary system. Sometimes there is increased urination and discomfort in the kidney area. Inflammation of the sciatic nerve and lumbodynia (pain in the lower back) can join the ailment.
Stages of osteochondrosis of the lumbar spine.
Unfortunately, osteochondrosis is an incurable disease and the process of destruction of the intervertebral discs is irreversible. There are four degrees of development of osteochondrosis:
- The first degree, in which the gelatinous nucleus within the disc changes and moves.
- The second degree is the period of destruction of the fibrous ring in the disc;
- The third degree, in which the fibrous annulus ruptures and the gelatinous nucleus leaves it, causing the formation of a herniated disc.
- The fourth degree is the period of development of the degenerative processes of the vertebrae with the participation of the intervertebral joints and ligaments. Osteoarthritis of the intervertebral joints (spondyloarthrosis) develops.
First grade
It is characterized by painful sensations due to irritation of the nerve endings located in the fibrous ring and longitudinal ligaments. The patient feels pain and discomfort in the affected disc section. The pain can be sharp, sharp or dull, it is permanent and it is localized in the lumbosacral segment. Very often it is detached from the leg, and sometimes it is only felt on the leg.
Irritation of nerve endings leads to the development of reflex syndromes. For this reason, a person does not always feel pain in the problem area, but much beyond. Also, there is a violation of the robots of internal organs, the appearance of reflex muscle spasms; circulatory disorders in the extremities and ligaments. Violation of blood circulation and nutrition of tendons and ligaments, which leads to pain and induration in the places of attachment to the bones.
Second grade
At this stage, there is a characteristic instability and increased mobility of the vertebrae, leading to persistent lubrication of the muscles. At the same time, it is difficult for a person to stand, he feels discomfort and pain in the lower back. Sometimes the lower back "hurts" and the patient does not understand why.
Third degree
It is characterized by the prolapse of disc fragments, manifested by compression of the nerve roots. During this period, there is a violation of sensitivity in the zone of innervation of the compressed nerve. In addition, there are unpleasant sensations in the form of tingling, burning, numbness, as well as a complete loss of sensitivity, which is accompanied by impaired motor function, sometimes leading to paralysis. Muscle atrophy, thinning and reduction are observed in the affected area. The areas where the changes described above are observed eloquently indicate the site of the spinal injury. A characteristic manifestation of the third degree is the appearance of the Lasegue symptom. It manifests itself as follows: when the patient is lying on his back, with the leg stretched upwards, there is severe pain in the lumbar region, spreading along the back of the raised leg. When the legs are bent towards the knees, the pain subsides immediately.
When fragments of the intervertebral discs fall into the lumen of the spinal canal, damage occurs to the spinal cord. Another syndrome, the so-called cauda equina, is manifested by alterations in the sensation and motor function of the legs, as well as the pelvic organs and the bladder.
Fourth grade
This period is characterized by the disappearance of pain and the restoration of the function of the musculoskeletal system. However, at the same time, there is a limitation of motor function. The spine, so to speak, becomes wooden, as the fibrosis of the disc develops and all its elements are replaced with dense scar tissue. At the same time, the intervertebral ligaments and joints are involved in the inflammatory process, and different degrees of the disease are also observed, which are manifested by polymorphism of symptoms.
How to treat osteochondrosis of the lumbar spine.
Treatment of osteochondrosis of the lumbar spine is a very long and persistent process. And most importantly, for the successful treatment of a disease, much depends on the person himself. After all, you will have to radically change your lifestyle and get rid of many everyday habits, as well as work on your health for the rest of your life.
In the opposite case, even successful drug treatment will not be able to completely eliminate the deformity of the spine. In addition, after a temporary improvement, the symptoms will return with a new intensity and treatment will have to be restarted. Although sometimes, even with the observance of the regimen of physical activity, attacks of osteochondrosis occur.
Therefore, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug treatment;
- non-pharmacological;
- surgery.
Conservative drug treatment
Since osteochondrosis of the spine cannot be completely cured and is an irreversible process, the goal of conservative treatment is to eliminate symptoms and prevent further progression of the disease. Before starting drug treatment, it is necessary to minimize physical activity. In severe exacerbations, bed rest is recommended. Sometimes this is more effective than medication.
To relieve symptoms of inflammation, use:
- NSAIDs (non-steroidal anti-inflammatory drugs). The drugs of this group effectively eliminate pain and inflammation in the vertebrae. Medicines can come in the form of pills or injections.
- Glucocorticosteroids. These drugs are classified as steroid hormones. Glucocorticosteroid injections are made directly into the joint cavity. Without fail, they are supplemented with B vitamins (B1, B6, B12).
- SedativesThey are necessary to eliminate the associated reflexogenic and psychogenic disorders.
- AnticonvulsantsEliminates involuntary contractions of skeletal muscles.
- AntidepressantsThe drugs of this group affect the level of neurotransmitters, as a result, the patient's mood improves, melancholy, anxiety and emotional stress disappear.
- Diuretic drugs. They are necessary for signs of root syndrome.
- Anticholinesterase drugs. Drugs of this group inhibit the activity of the cholinesterase enzyme, as a result, the conduction of nerve impulses increases.
- Chondroprotectors. Necessary to avoid deformation of the vertebral discs and joints.
In an acute attack, a novocaine blockade (the introduction of anesthetic drugs directly into the affected area) is prescribed.
Symptoms of lumbar osteochondrosis in women manifest themselves differently than in men. In women, the menstrual cycle can be altered, as well as gynecological diseases can develop: inflammation of the ovaries and uterus (endometritis). Reproductive damage can also occur. In this case, you need the help of a qualified gynecologist.
How to treat lumbar osteochondrosis at home
The main principle of home treatment is to eliminate the symptoms that prevent a person from leading a quality lifestyle.
The following treatment methods are used at home:
- Diet. Most often, the cause of osteochondrosis is the accumulation of cholesterol and the loss of vascular elasticity. To remedy the situation, you need to follow a low-fat diet. Also exclude from the diet foods high in cholesterol: eggs, pork, rich broths, chicken skin. Completely eliminate alcohol and nicotine, reduce the consumption of strong coffee and tea. They lead to vasospasm.
- Restoration of blood supply in the lumbar region. To do this, use both rubbing with ointments and medicinal compresses, as well as physical therapy exercises, which can be performed at home.
- Orthopedic sleeping aids. Since the spine is the axis of the human body, which undergoes enormous stress during the day, it needs adequate rest. In this capacity, orthopedic mattresses and pillows act, which are capable of giving the spine the correct position during sleep.