Pain in the back and lumbar region 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 great variety of pathologies can cause pain in the lower back, but very often it is caused by osteochondrosis of the lumbar region.How to treat 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 age symptom is not exclusive; osteochondrosis of the lumbar spine is diagnosed in patients in various age groups.Today, the cut-off age is considered to be more than 25 years.
Causes of lumbar osteochondrosis
It is impossible to name the exact reason; almost always it will be the complex impact of various destructive factors, among which the most important can be identified:
- Commitment to a passive lifestylefrom the point of view of motor activity.By their own will, immobilized people, for example, spending many hours at a computer, do not receive enough useful load, which is why the “corset” muscles relax and the load on the vertebrae increases.In addition, almost always such a pastime is associated with prolonged exposure to incorrect and unnatural positions.
- Problems with hormonal levels, leading to metabolic disorders, which affects the metabolism of spinal tissue in the lumbar region and contributes 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 spinal column, for example, in a patient with flat feet, curvature of the legs or spine.
- Chronic increased loadson the lower back.Here, the risks include people with certain types of professional activities, usually associated with heavy lifting.This also includes professional athletes who constantly subject their bodies to peak loads.
- Disrupted food intake and daily routine.This also includes regular exposure to stress.These factors affect metabolic processes and influence the body’s periodic restoration of its 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 practically asymptomatic at the beginning or causing hardly tolerable pain during late development.Let's consider the main degrees of development of osteochondrosis:
- A situation in which the nucleus pulposus moves within the intervertebral disc.It is characterized by pain caused by irritation of the nerve roots of the fibrous ring and longitudinal ligaments.Discomfort is felt locally in the area where the defective disc is located.The pain can be either acute with shooting or constant dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the elements of the spinal column in this area increases, they become unstable relative to each other.To eliminate these pathological manifestations, it is necessary to constantly keep the muscles of this area tense, which ultimately leads to chronic fatigue in the lower back.
- Next, a breakthrough occurs in the fibrous ring, which causes the nucleus to escape beyond the border of the disc, forming an intervertebral hernia.Such a case will be accompanied by pinching of the nerve endings, which is called “radicular 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, oddly enough, subsides at this stage.However, you should not rejoice; this does not mean that the disease is dying out.
- The last degree is characterized by pathological growth of bone tissue and a general deterioration in 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, the area of their localization and the direction in which they spread may 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 aching pain in the lower back, which tends to intensify with sudden movement or, conversely, 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 extremities, is likely, as well as a blunted tendon reflex in the legs.
- There is a high probability 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 talk about scoliosis, lordosis is the situation of forward bending, and kyphosis is the case when the natural lumbar curve is, as it were, smoothed out.
- With a serious degree of development of the disease, pinching of the spinal cord canals is possible, which can cause its dysfunction and lead to uncontrolled urination and stool.
Additional symptoms include:
- The presence of numbness and “coldness” of the skin of the lower back and buttocks.
- Flaky, dry and blue skin in the same places.
- Impaired urination.
- Erection problems.
The presence of these symptoms should alert a person; one should not give up on them, this will only lead to greater neglect.In this case, you should definitely consult a doctor for accurate diagnosis and treatment.By the way, treatment can be 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 palpation in the lumbar region to identify areas of pain.Typically, this method is not very informative and in addition, examinations are carried out that give a more detailed clinical picture:
- By radiography, 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 accurate; it only allows us to indirectly understand how intact the intervertebral discs and spinal canals are.
- Computed tomographya 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 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 the pathology are hernias and protrusions, which inevitably occur if treatment is neglected and the development of the disease is left to chance.Other complications may include:
- Inflammation of the sciatic nerve.
- Spondyloarthrosis.
- 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 therapy is required, the main aspects of which will be:
- Application of moderate loads.
- Special medicines.
- Traction of the spinal column.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of “treatment” for osteochondrosis implies:
- Suppression of inflammation.
- Relieving pain syndrome.
- Complex for strengthening the lumbar and adjacent muscle groups.
- Relief from chronic muscle tension.
- Increasing the functionality of organs in the pelvis.
- Normalization of blood circulation and metabolism in the pathological area.
Treatment with medications
A similar approach to the treatment of lumbar osteochondrosis includes taking medications, 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.
- Drugs against inflammation 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 serious pathologies, when the above remedies do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these medications, medications are prescribed in tablets, the purpose of which is to calm the nervous system and combat stress and depression.
Physiotherapy treatment for lumbar osteochondrosis
The treatment process is rarely limited to just taking pills.The pathology in question cannot be cured without stimulating the restoration processes of the spine.For these purposes, a wide range of physiotherapeutic procedures are used, the most popular of which are:
- Phonophoresis.
- Therapy with diadynamic currents.
- Laser therapy.
In addition, the spine needs to be given useful loads while simultaneously stretching it.Various types of therapeutic massage are ideal 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 process of remission of the disease has begun, or in chronic osteochondrosis.After a massage, muscle muscles overstrained by illness are well relaxed; its effect will be significantly enhanced when simultaneously warmed up, for example in a bathhouse or sauna.In the latter case, we will achieve maximum effect due to additional stimulation of blood circulation in the pathology zone and adjacent areas.
Another method of physical therapy is manual therapy.Its advantages are generally the same as those of massage, but in addition, with the help of such techniques, a specialist is 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 is the regularity of the exercises; in this case, the damaged area will constantly receive the necessary physical activity for the self-generation of new tissue and recovery.
Surgical operations for lumbar osteochondrosis
Surgery is a last resort, which is prescribed for serious 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, being a measure of last resort, it is prescribed only 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.