Back and lower back pain is one of the most common complaints in medicine.They are in second place in terms of number of requests, second only to respiratory diseases.A wide variety of pathologies can cause pain in the lower back, but most often it is caused by osteochondrosis of the lumbar region.How to treat such a disease, what symptoms and signs it presents, will be discussed below.
Not so long ago, medical science believed that osteochondrosis in the lumbosacral region occurs exclusively due to age-related changes leading to wear and tear of the vertebrae and intervertebral discs.Today, however, the symptom of age is not exclusive;osteochondrosis of the lumbar spine is diagnosed in patients of various age groups.Today it is believed that the limiting age is above 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.Of their own free will, immobilized people, for example, who spend many hours at the computer, do not receive enough payload, which is why the "corset" muscles relax and the load on the vertebrae increases.Furthermore, such a pastime is almost always associated with prolonged exposure to incorrect and unnatural positions.
- Problems with hormone levels, leading to metabolic disorders, which affect the metabolism of the spinal tissue in the lumbar region and contribute to destructive processes.This also includes diseases of an endocrine nature.
- Presence of congenital or acquired anomalieswhen the musculoskeletal system undergoes certain changes.This may be reflected in an increased load on the spine, for example in a patient with flat feet, curvature of the legs or spine.
- Chronic increased loadson the lower back.In this case, 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 influence metabolic processes and affect the periodic restoration of strength by the body.
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 pain that is difficult to tolerate during advanced development.Let's consider the main degrees of development of osteochondrosis:
- 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 annulus fibrosus and longitudinal ligaments.Discomfort is felt locally in the area where the defective disk is located.The pain may be sharp with constant twinges or dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the spinal elements in this area increases and 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.
- Subsequently, a breakthrough occurs in the fibrous ring, which causes the nucleus to protrude beyond the edge of the disc, forming an intervertebral hernia.Such a case will be accompanied by pinching of the nerve endings, called "radicular syndrome".
- The next degree of osteochondrosis of the lumbosacral region occurs with severe deformation of the spine in this part.Mobility problems appear, but the pain syndrome, oddly enough, disappears 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 of health.
Depending on the degree of lumbar osteochondrosis, certain treatment methods are used.
Symptoms of osteochondrosis in the lower back
The main symptom is fighting syndrome in the lumbar spine.At the same time, pain sensations, the area of their localization and the direction in which they spread may vary.This happens because, depending on the extent of damage to the intervertebral disc and surrounding tissues, certain nerve receptors become irritated.In addition, the presence of a protrusion or 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 movements or, conversely, remaining for a long time without changing position.The pain decreases if you take a horizontal position.
- Additionally, weakness in the area of the body below the abdomen, including the lower extremities, is likely, as is 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, it is called scoliosis, lordosis is the situation of forward bending, and kyphosis is the case when the natural lumbar curve is, so to speak, smoothed out.
- With a severe degree of development of the disease, pinching of the spinal 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.
- Skin scaly, dry and bluish in the same places.
- Impaired urination.
- Erection problems.
The presence of these symptoms should alert a person;we must not give it up, this will only lead to greater abandonment.In this case, you should definitely consult a doctor for accurate diagnosis and treatment.By the way, treatment can take place in a hospital or home setting, but more on that later.
Diagnosis of the disease
When making a diagnosis, it is important to understand how far the disease has progressed.The simplest way is palpation in the lumbar region to identify areas of pain.Typically, this method is not very informative, and additionally, tests are performed that provide a more detailed clinical picture:
- For radiography, an inexpensive and very widespread method, it is possible to evaluate the state of both the spine as a whole and individual vertebrae, for example the affected lumbar region.The technique is not very precise;it only indirectly allows us to understand how intact the intervertebral discs and spinal canals are.
- Computed tomographya more accurate method that allows you to evaluate the level of damage to the 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 therapeutic 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 crushed spinal canals.
- Functional disorders in the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When osteochondrosis of the lumbar spine is diagnosed, a wide range of therapies is needed, the main aspects of which will be:
- Application of moderate loads.
- Special medicines.
- Spinal traction.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of “treatment” for osteochondrosis implies:
- Suppression of inflammation.
- Relieve pain syndrome.
- Complex for strengthening the lumbar and adjacent muscle groups.
- Relief from chronic muscle tension.
- Increase the functionality of the pelvic organs.
- Normalization of blood circulation and metabolism in the pathological area.
Treatment with drugs
A similar approach to the treatment of lumbar osteochondrosis involves 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.
Depending 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 remedies indicated above do not help, corticosteroids are used.
- Vitamin complexes.
In addition to these drugs, tablet drugs are prescribed, 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 this purpose, a wide range of physiotherapeutic procedures are used, the most popular of which are:
- Phonophoresis.
- Diadynamic current therapy.
- Laser therapy.
In addition, it is necessary to load the spine with useful loads and at the same time stretch it.Different types of therapeutic massages are ideal for this purpose.It should 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, the muscles tensed by the disease are well relaxed;its effect will be significantly enhanced if heated at the same time, for example in a bath or sauna.In the latter case, we will achieve the maximum effect due to additional stimulation of blood circulation in the pathological zone and adjacent areas.
Another method of physical therapy is manual therapy.Its advantages are generally the same as massage, but in addition, with the help of such techniques, a specialist is able to return the displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercises are also used as a restorative and preventative 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 physical activity necessary for the self-generation of new tissues and recovery.
Surgical interventions for lumbar osteochondrosis
Surgery is a last resort, prescribed in case of serious complications.The most common of these is intervertebral hernia, when the 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 therapeutic methods 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.