Despite popular belief, spinal osteochondrosis is not considered part of the aging process. The elastic discs between the vertebrae are responsible for bending and lengthening the back, like shock absorbers. Over time, they wear out and no longer provide full range of motion. With age, daily stress on the spine and accidental injuries, including minor ones, can damage the discs in the back and lead to osteochondrosis of the lumbar spine.
Who is affected by this low back disease?
In most cases, the first symptoms of osteochondrosis of the lumbar spine appear at the age of 11-12 years. The disease manifests itself vividly by the age of sixteen, but the most severe course and frequent complications occur between the ages of 15 and 20.
Children under the age of 15 rarely have severe forms of osteochondrosis, which is somehow related to the excellent condition of their musculoskeletal system in general and the spine in particular. In addition, the disease takes time to develop and takes an average of five years.
Fortunately, these diseases are much easier to treat in children than in adults.
Symptoms
Reflex syndromes
- Cervicalgia- variously manifested pain in the neck (pulling, tingling, shooting), a feeling of "tingling" in the neck muscles, as well as reduced mobility and flexibility of the neck.
- Lumbagois a sharp, sharp pain in the lumbar region that may be accompanied by tingling or swelling. The words "lumbodia" or "lumbosciatica" may be used instead of the word "lumbago".
- Thoracalgia- pain of various nature in the chest, shoulders and ribs, which are constantly present or occur during body movements.
Compression syndromes
The onset of pain syndrome in osteochondrosis of the lumbar spine is due to:
- Compression of root structures (radiculopathy).
- Compression of the spinal cord (myelopathy).
- Trauma to the spinal cord due to impaired blood supply.
- Narrowing (stenosis) of the arteries and veins (compression-vascular myeloischaemia).
Disease detection methods
Differential diagnostics
Not every disorder can be diagnosed with a simple laboratory test. Many conditions cause similar symptoms. For example, many infections cause fever, headache and fatigue.
Many mental disorders are caused by:
- sadness;
- concern;
- sleep problems.
The differential diagnosis identifies possible disorders that cause symptoms. This diagnosis is usually based on several tests. These tests may rule out conditions and / or determine if you need additional testing.
Differential diagnosis is used to diagnose physical or mental problems that cause similar symptoms.
Differential diagnosis is also commonly used in psychiatry / psychology, where two different diagnoses can be made of a patient who has symptoms of several diseases. For example, a patient diagnosed with bipolar disorder may also be differentially diagnosed with borderline personality disorder, given the similarity of the symptoms of the two conditions.
Who is diagnosed more often?
If earlier the disease was diagnosed in sick people after 45 years, today about 27% of adolescents suffer from osteochondrosis of one degree or another.
Such a huge spread of the disease is understandable - children began to spend a lot of time in a sitting position, including because of the computer and the Internet. Is it bad? Time will tell, but the fact remains - the pay for a sedentary lifestyle is high, and osteochondrosis is far from the worst disease that can occur in such a lifestyle, but it is the most common (after obesity).
How to determine the disease and its degree?
First
In the normal state, the intervertebral discs are constantly regenerating, but it happens that the process slows down and a disease such as 1st degree osteochondrosis occurs.
There are many reasons for this:
- obesity;
- metabolic disorders;
- immunocompromised and so on.
First degree lumbar spine osteochondrosis can be cured quite easily by contacting a good specialist and performing a number of simple actions.
Grade 1 osteochondrosis is a thickening of the intervertebral cartilage in the lumbar spine. The main symptom at this stage is slight pain when turning or bending. Sometimes the symptoms are more acute and short-lived due to sudden movements or significant loads.
Second
A pronounced symptom of the disease is pain in the lumbar region, which increases with each movement. The pain may radiate up the spine.
In osteochondrosis, the pain may radiate to the lower extremities.
The second stage of osteochondrosis is characterized by such severe pain that it occurs even with a cough.
Additional symptoms are associated with pinched nerve endings:
- Sensitivity in the lower extremities changes. The main signs are: pain, tingling in the legs, high or too low level of sensitivity of the skin of the lower extremities.
- Limited mobility. A person suffering from osteochondrosis (grade 2) notices that as the disease progresses it becomes very difficult to move.
- Increased fatigue and constant drowsiness. The patient has chronic fatigue accompanied by irritability. This symptom is explained by the pain syndrome, which constantly worries the person.
- Problematic urination and pain in the kidneys.
Third
By the time the patient reached stage 3, his posture had changed significantly. In more advanced cases, bone deformity occurs. At this stage of lumbar spine osteochondrosis, there is also an obvious deterioration in the general physical and / or mental condition of the patient and a profound loss of energy.
The third stage is characterized by the appearance of narrowing of the intervertebral foramen against the background of previous changes. Herniations of intervertebral discs are formed, the vessels of the neck and muscles are damaged. The patient has dizziness, pain in the back of the head.
Fourth
The terminal stage occurs when the intervertebral disc degenerates and the disc space is destroyed. At this stage, the thinning of the disk reaches its maximum or, even worse, disappears completely. Postural imbalance is acute and movement and flexibility are extremely limited.
Stage 4 osteochondrosis of the lumbar spine is often characterized by severe pain and a higher degree of physical and / or mental deterioration. There is also a permanent loss of growth and energy levels. Stage 4 is generally considered irreversible.
Consult a doctor
Which doctor should I go to?
When independent treatments cease to have an analgesic effect, the patient begins to ask the question: which doctor treats osteochondrosis? The first person you can turn to for treatment of osteochondria of the lumbar spine is your local therapist. But in this situation he plays the role of dispatcher, as he will not be able to prescribe full treatment - this is not his specialization.
He will probably refer you to a neurologist. It is this specialist who will conduct the necessary research and help build a treatment program. The therapist may also refer you to a vertebrologist. This doctor deals directly with diseases of the spine.
Scales and tests
Quality of Life Assessment
Such a generalized characteristic as quality of life is particularly important for a group of patients with comorbidities, as they may affect the effectiveness of treatment. This is especially important for comparing the results of several studies, economic analysis and for understanding the problem as a whole.
Quality of life assessment methods include:
- Oswestry Quality of Life Questionnaire. Roland-Morris questionnaire.
- Stratford Rock.
- Back pain scale in Quebec - a questionnaire on how back pain affects your daily life).
Pain scales
Pain is an unpleasant sensation and emotional experience associated with tissue damage. Its purpose is to enable the body to react and prevent further tissue damage.
Methods for assessing pain syndrome include:
- Korf's chronic pain rating scale won.
- McGill Pain Questionnaire.
- Verbal scale of pain.
Evaluation of treatment outcome
- Subjective rating scale of McNab.
- Patient satisfaction scale.
- Scale of functional and economic results.
- Lumbosacral scale of results.
- Nurik Rock.
Hardware test
x-ray
X-rays provide detailed bone structures in the spine and are used to rule out back pain resulting from:
- Spondylolisthesis.
- Tumors.
- Cracks.
Calcium in the bone blocks the penetration of X-rays and the image of the bones is perceived as a shadow on the film. X-rays provide excellent visibility of all details, as the bone consists mainly of calcium. However, discs and nerve roots do not contain calcium, so X-rays do not capture images of these structures. Therefore, X-rays cannot be used to diagnose lumbar disc herniation or other causes of a pinched nerve.
X-rays should not be given to pregnant women.
Complications and possible consequences
Complications and possible consequences of osteochondrosis of the lumbar spine include:
- Radiculopathy is a condition characterized by nerve root disease.
- Muscle weakness - Common symptoms include fever, fatigue, flu-like symptoms, paresthesias, weight loss and changes in consciousness.
- Neurogenic bladder - problems with the nerves that control the bladder and urination
- Damage to the lower motor neurons.
- Raynaud's phenomenon is a condition in which spasms occur, narrowing of the capillaries of the fingers and toes.
- Pain in neck, back, legs.
Treatment
Treatment may vary depending on the severity of your symptoms and the extent to which they limit your daily activities.Here are some of the treatments your doctor may prescribe based on your pain level:
- Non-surgical treatment- not all patients with osteochondrosis need surgery. In mild to moderate pain, more conservative treatments.
- Spondylodesis- surgical intervention in the treatment of osteochondrosis.
Prevention
Prevention of lumbar segment osteochondrosis is to eliminate the risk factors leading to this disease. Elimination of factors is the main preventive measure.
Physical activity is normalized, the back muscles are strengthened, the maximum load on the lower back is prevented, the development of diseases leading to low back pain is prevented, all this is prevention for the prevention of lumbar osteochondrosis symptoms.
Moderate exercise, lifestyle changes, and good nutrition can help prevent painful and disabling symptoms.
If you notice symptoms of osteochondrosis of the lumbar spine, do not tighten and consult a doctor immediately. Timely detection of the disease is easier to treat and proceeds without consequences.