The elderly, professional athletes, as well as those whose work involves prolonged sitting or standing, are often exposed to various diseases of the musculoskeletal system. Irrational daily menu, physical inactivity lead to wear and tear, destruction of bones and cartilage. As a result, osteochondrosis of the lumbar spine develops, whose symptoms and treatment depend on the personal characteristics of the body, as well as the severity of the lesion.
According to the international classification of diseases from the 10th revision of this disease was assigned the code M42. Sometimes patients are given cumbersome diagnoses, and coding simplifies doctors' work. This short alphanumeric designation can be recorded in the medical history, ambulatory card. So what is osteochondrosis of the lumbar spine? What are the reasons for its occurrence? What are the manifestations of the disease? This post tells you everything.
Causes of lumbar osteochondrosis
Osteochondrosis of the lumbar spine often causes trauma and a slow lifestyle. Among other things, one of the main roles is played by burdened heredity, just like the hormonal, chemical, psychogenic background of the body.
If parents have suffered from lumbar osteochondrosis, symptoms and treatment are likely to occur and be passed on to their children. Once they have inherited the predisposing factors, the offspring also run the risk of facing this disease.
Provocative factors include the following causes:
- Other diseases, such as digestive tract, liver, pelvis, nervous system;
- Jump to slow metabolism;
- Displacement of acid-base balance to oxidation (acidosis);
- Reduced motor energy;
- Stress, nervous situations;
- Long awkward postures, incorrect posture.
Often sacral osteochondrosis occurs as a result of hypothermia, hormonal disorders or as a result of pathological congenital defects of the spine.
Symptoms of lumbar osteochondrosis
The signs of lumbar osteochondrosis are related to the fact that the spinal nerve fibers pass into the back area inside the spinal canal. Depending on the location, the severity of the defeat of some roots, the manifestations of the disease vary.
In osteochondrosis of the lumbar spine, the symptoms are as follows:
- Pain Syndrome- Most patients complain of low back pain in osteochondrosis. The pain is local directly in the area of the disorder or it radiates to the gluteal area, the sacrum of the leg on the side of the lesion;
- Sign of tension- the pain increases with a certain position, but when the position of the body changes, the pain disappears abruptly. The most commonly used test is named after the discoverer - Lasegue syndrome - the pain increases when lifting the right limb and disappears when the leg is bent at the knee;
- Decreased or increased sensitivity- this symptom is directly related to damage to the radicular nerves, sensitivity is impaired not at the site of pathology, but at some distance. The patient has hypoesthesia, hyperesthesia or paresthesia, which is characterized by unusual projection sensations such as tingling, numbness, etc.
Often, in lumbar osteochondrosis, motor activity decreases, this is associated with muscle atrophy to varying degrees. In some circumstances there is a restriction of functions, in other situations paralysis and paresis occur.
Also, lumbar chondrosis is associated with damage to the spinal vessels, with their irritation and spasm vegetative changes occur. Blood circulation in the legs slows down, the lower extremities are constantly frozen, there is pallor of the skin. Other organs in the lumbar region are often affected. So, with damage to the bladder develops urinary incontinence or, conversely, delay.
Stages of the disease
- Grade 1 lumbar osteochondrosis is the initial type of pathology. It is characterized by low density of intervertebral discs. The pain syndrome appears with a sharp turn of the body, after exercise or prolonged sitting.
This type of disease is common in drivers, office workers, athletes and people working in harsh climates. The pain is not characterized by acute attacks, but develops as debilitating dull or painful.
At this stage, people are in no hurry to go to doctors, but use traditional methods of treatment, such as ointments, compresses. The situation leads to the fact that osteochondrosis of the lumbar or sacral part of the spine passes into the second stage;
- Lumbar osteochondrosis of the 2nd degree - degenerative and dystrophic disorders of the spinal joints occur. The fibrous spinal ring is compressed as the nucleus pulposus grows and a protrusion (protrusion) of the intervertebral disc occurs.
Neurologists define the second stage of osteochondrosis as lumbago. In other words, lumbago occurs in the lower back when a heavy object is suddenly lifted or with other loads. This period lasts for many years, the stages of remission alternate with acute attacks of exacerbations;
- Lumbar osteochondrosis of the 3rd degree - the protrusion of the pulp gradually increases, an intervertebral hernia is formed. The patient develops the full range of neurological status: constant pain, radiation to the buttocks, abdomen, coccyx, legs, urethra, limited mobility.
The legend is used to locate the hernia. The diagnosis of osteochondrosis L5 S1 means that the bulge of the pulpal nucleus occurred between the 5th lumbar and 1st cruciate vertebra;
- When therapeutic measures are not taken in time, all stages of development move smoothly to the next stage. Stage 4 lumbar osteochondrosis is characterized by the development of complications.
As a rule, drug treatment of highly developed pathology is characterized by low effectiveness. The neurologist is obliged to propose a radical method of action, ie hernia surgery.
Methods for diagnosing osteochondrosis
To identify osteochondrosis of the EPP, the neurologist first makes a history, as the patient's complaints are one of the crucial values for an accurate diagnosis. During the conversation the patient is asked questions about his health and condition - what and where it hurts, what is the duration of the pain, what increases the feeling when stiffness has occurred, whether the treatment was performed, what it was and the like.
Mandatory diagnostic diagnostic methods are used:
- Overview Rg-graphic image of the lumbar spine- the spine is taken as a whole or individual segments of it are photographed. More often than others, the referral Rg-gram is made on the basis of complaints in which the doctor notices atrophy of the disc, reduction of the intervertebral space, the appearance of osteophytes, smoothing of the lumbar bend;
- Myelography- The contrast fluid is injected into the canal where the spinal cord passes through the spinal cord. The technique is used to determine the internal structure of the channel. Ordinary people think that the procedure is difficult and dangerous to diagnose, but apart from an allergy to contrast, the puncture of the spinal canal practically does not threaten the patient. The puncture is made where the spinal cord is missing;
- Computed tomography- compression of nerve roots, convexity of the pulp is determined, vertebral bodies, ligaments, vessels, soft tissues are easily visible on the monitor;
Most precisely, sacral osteochondrosis is determined with the help of electromagnetic waves, for which the patient is assigned to an MRI scan.
Each tissue has its own input signal, the computer processes the data and displays the image on the screen. The doctor examines the vessels, discs, bone processes, nerve fibers in an incision of 1 mm. At the same time, the patient does not receive harmful ionizing effects.
Treatment of osteochondrosis of the lumbar spine
Many patients are interested in the question: what to do with osteochondrosis of the lumbar region? Osteochondrosis of the lumbar spine is not always indicated for surgery. The main thing is that after a thorough examination of the patient, the usual therapeutic measures are sufficient.
Conservative therapy is reduced:
- For medical treatment;
- Physiotherapy procedures;
- Gymnastic exercises from exercise therapy.
Also for the treatment of osteochondrosis of the lumbar spine are used methods of manual therapy and methods of traditional medicine.
For the treatment of osteochondrosis of the lumbar spine, the surgical method is offered to patients only in extremely severe cases, if conservative methods have not given the desired results.
Medicine
The treatment of osteochondrosis of the lumbar spine is performed by a neurologist or the narrowest vertebrologist. Before treating lumbar chondrosis of the spinous processes, the doctor determines the stage and severity of the pathological disorders.
Muscle relaxants are used to relieve pain, reduce spasms, inflammation. These drugs quickly restore the patient's mobility, relieve spasms, so the pain disappears.
In addition to the group of drugs for muscle relaxation, steroid hormones are sometimes used to eliminate swelling and inflammation.
Therapeutic gymnastics
The treatment of lumbar osteochondrosis should be carried out in conjunction with the methods of exercise therapy. Exercise and gymnastics should be given the same attention as the use of drugs.
The therapeutic effect of osteochondrosis are those exercises that relieve pain, strengthen the muscular frame, reduce compression between the discs - this slows down the further progression of the disease.
Physiotherapy
In lumbosacral osteochondrosis treatment includes the use of the following procedures:
- Drug electrophoresis;
- Laser and magnetic therapy;
- Magnetic current treatment;
- Darsonval;
- UV radiation;
- diadine treatment;
- Shock wave method.
Manipulations include the use of means using natural physical force: currents, light radiation, vibrations, etc. The scheme of treatment, the duration of the course of physiotherapy is determined by the attending physician.
Manual therapy
When a sick person asks a neurologist how to treat lumbar spine osteochondrosis with the help of a manual technique, he is usually advised by a qualified specialist who not only affects the muscle tissue with his hands, but also puts the vertebrae in place.
In the case of lumbar chondrosis, this method normalizes blood circulation and lymphatic circulation, eliminates muscle tone and deformity and restores motor function. The chiropractor's hands reduce the purity of the spasms, reduce back pain.
How is lumbar osteochondrosis treated with manual techniques and is it possible to fully recover in this way? Manual therapy is prescribed only when the degenerative processes have not damaged the tissues of the spine, ie no bone growths have formed. The need for procedures is determined by the doctor after Rg-diagnosis, CT or MRI.
Surgery
The treatment of lumbar chondrosis by surgery is performed according to certain indications, when the pathology is characterized by the following changes in the spine:
- The spinal canal narrows, the intervertebral discs compress and destroy;
- Cauda equina syndrome develops - a massive bundle of nerves of the spinal cone is damaged, which innervates the pelvic area, the legs;
- Progressive loss of sensitivity, there is a violation of the functioning of internal organs;
- There is a risk of paralysis of the legs.
The operation is performed according to emergency or planned readings. The goal of surgical treatment is to relieve pressure and improve the condition of the spine.
Traditional medicine
Treatment of osteochondrosis of the lumbar spine with folk methods is best done after consultation with your doctor.
The folk pharmacy offers many remedies for the treatment of diseases:
- Medicinal herbs, essential oils, flower extracts, plant roots;
- Animal products, such as snake or bee venom, badger, dog, sheep fat, boiled eggs and others;
- Iodine, turpentine and alcohol are used for warming, irritating effects.
Like drugs, chondrosis of the waist is treated with folk methods only in the initial stage of the disease, until the symptoms are eliminated, but the pathological changes do not disappear. Among other things, such treatment often has side effects, which is why consultation with a specialist is required before using any prescription from traditional medicine.
The dosage of any people or medicine should be prescribed by your doctor.
Complications
Lumbar chondrosis in the last stage can lead to unpleasant consequences, including damage.
Against the background of dystrophy and degenerative disorders, narrowing of the spinal canal develops stenosis. As a result of such changes, a chronic type of compression is formed, which interferes with normal blood flow, root ischemia or cauda equina syndrome develops.
In addition, diseases such as spondylosis and spondyloarthritis sometimes develop - the intervertebral discs age, lose strength, and pull pain occurs due to the damaged structure of the spinal joints. Complications most often relate to the ridge of the lower part of the spine, where spine-like bone growths form.
In the third stage, as a complication of osteochondrosis, intervertebral hernias develop, diseases of the genitourinary system and other internal organs appear.
Preventive measures
Prevention of osteochondrosis of the lumbosacral spine is of great importance. The lower back has the greatest load, so you need to be especially careful with your back. It is worth remembering that regular exercise is the key to a healthy spine.
Weights should be lifted with the utmost care, avoiding sudden pulls. Men and women can carry loads that are within reason.
Sitting in the office, you need to monitor your posture, take the correct posture and sit in a chair with your back straight. It is good to get up every hour and walk around the room, do squats, turn the torso: this relieves the tension of the entire musculoskeletal system.
The trigger point massage is great. They are active or in hidden form. Trigger points occur as a result of overexertion, strong stretching, repetitive work, stooping, hypothermia and other factors.
Knowing the reasons for the development of spasmodic areas, it is necessary to take measures to exclude their formation. Recently, the popular trigger point massager has gained popularity, it is better to prevent the appearance of painful foci with a special device than to treat them long and expensive.