Osteochondrosis of the lumbar spine is a pathological change in the cartilage and bone tissue of the intervertebral discs of the lumbosacral spine. This change can be natural or the result of an unhealthy lifestyle. In old age, the processes of involution of bone and cartilage tissue begin in everyone. But when these phenomena are premature (appear in people of middle age), then we are talking about pathological processes of the skeletal system. The pathology affects both men and women over the age of 30.
Lumbar osteochondrosis is the best known and most common disease of the spine, which manifests as severe pain in the lumbar region. The disease develops as a result of metabolic disorders, which lead to inadequate 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, which leads to narrowing of the holes for nerve endings) are formed on the vertebrae.
Reasons for the development of osteochondrosis of the lumbar spine
Lumbar osteochondrosis occurs much more often than osteochondrosis of the thoracic or cervical spine, as the lower back is most stressed when walking and running, with prolonged sitting in a chair or lifting weights.
Since this anatomical site bears 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. Between them are intervertebral discs, which give the spine flexibility and mobility. In turn, the intervertebral discs consist of a gelatinous nucleus, located inside a hard fibrous ring. When osteochondrosis develops, the normal nutrition of the discs is disturbed, as a result they become thinner, lose elasticity, and the distance between them decreases. As a result, the nerve roots are violated, which leads to severe pain and even disability.
Thus, the reasons for the development of this pathology are:
- Injury of the spine;
- diseases of the endocrine, digestive and cardiovascular systems;
- intense physical activity (lifting weights, running hard);
- sedentary lifestyle;
- dysfunctions of the hormonal system;
- flat foot;
- anomalies of the intervertebral discs;
- old age;
- inflammatory joint diseases, such as rheumatoid arthritis.
The risk factors for the development of the disease are:
- curvature and poor posture;
- bad lifestyle;
- unhealthy diet, obesity;
- being in the wrong posture for a long time;
- hereditary factor;
- stress;
- hypothermia.
The main symptom of the disease is lower back pain. It can be felt immediately or after intense 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 painful sensation (lumbago) after hypothermia of the body;
- violation of the sensitivity of the buttocks, thigh, lower leg and foot;
- paresis in the legs;
- chills in the feet;
- spasm of the arteries of the feet;
- excessive sweating;
- dryness and peeling of the skin in painful places.
Osteochondrosis of the lumbar spine can be exacerbated by any awkward movement, for example, when moving or rotating the body to the side. In this case, the pain is felt not only in the lower back, but also in the legs. There is also a strong spasm of the lumbar spasm, as the body thus 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 dysfunction 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) may join the disease.
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, at which the gelatinous nucleus inside 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 ring ruptures and the gelatinous nucleus leaves it, which causes the formation of a herniated disc.
- The fourth degree is the period of development of degenerative processes of the vertebrae with the involvement of the joints and intervertebral ligaments. Osteoarthritis of the intervertebral joints (spondylarthrosis) develops.
First degree
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 section of the affected disc. The pain can be sharp, sharp or dull, is permanent and localized in the lumbosacral segment. Very often it gives off in the leg, and sometimes it is only felt in the leg.
Irritation of nerve endings leads to the development of reflex syndromes. Because of this, a person does not always feel pain in the problem area, but much beyond it. In addition, there is a violation of robots of internal organs, the appearance of reflex muscle spasms; circulatory disorders of limbs and ligaments. Violation of blood circulation and nutrition of tendons and ligaments, which leads to pain and induration in places of attachment to bones.
Second degree
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 up, 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, which is manifested by compression of the nerve roots. During this period, there is a violation of sensitivity in the area 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. In the affected area, muscle atrophy, thinning and reduction are observed. The areas where the changes described above are observed eloquently indicate the place of the spinal injury. A characteristic manifestation of the third degree is the appearance of the symptom of Lasègue. It manifests itself as follows: when the patient is lying on his back with the right leg up, there is severe pain in the lumbar region, which extends along the back of the raised leg. When the legs are bent in the knees, the pain immediately goes away.
When fragments of intervertebral discs fall into the lumen of the spinal canal, the spinal cord is damaged. Another syndrome, called a cauda equina, is manifested by impaired sensitivity and motor function of the legs, as well as the pelvic organs and bladder.
Fourth degree
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 in motor function. The spine, so to speak, becomes woody, as disc fibrosis develops and all of its parts are replaced by dense scar tissue. At the same time, ligaments and intervertebral joints are involved in the inflammatory process, and different degrees of the disease are also observed, which is 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 success of the treatment of a disease, a lot depends on the person himself. After all, he will have to drastically change his lifestyle and get rid of many daily habits, as well as work on his health for the rest of his life.
Otherwise, even successful drug therapy 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 the treatment will have to be started again. Although sometimes, even with observance of the regimen of physical activity, attacks of osteochondrosis occur.
Thus, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug therapy;
- non-drug;
- operation.
Conservative drug therapy
Since osteochondrosis of the spine cannot be completely cured and it is an irreversible process, the goal of conservative treatment is to eliminate the symptoms and prevent the progression of the disease. . Before starting drug therapy, it is necessary to minimize physical activity. In case of severe exacerbations, bed rest is recommended. Sometimes it is more effective than medication.
To relieve symptoms of inflammation, use:
- NSAIDs (nonsteroidal anti-inflammatory drugs). Drugs of this group effectively eliminate pain and inflammation of the vertebrae. Medicines can be in the form of pills or injections.
- Glucocorticoids. These drugs are classified as steroid hormones. Glucocorticoid injections are made directly into the joint cavity. For sure, they are supplemented with B vitamins (B1, B6, B12).
- Sedatives. They are necessary to eliminate the associated reflexogenic and psychogenic disorders.
- Anticonvulsants. Eliminates involuntary contractions of skeletal muscles.
- Antidepressants. Drugs of this group affect the level of neurotransmitters, as a result, the mood of the patient improves, melancholy, anxiety and emotional stress disappear.
- Diuretic drugs. They are needed for the signs of radicular syndrome.
- Anticholinesterase drugs. Drugs in this group inhibit the activity of the enzyme cholinesterase, which increases the conduction of nerve impulses.
- Chondroprotectors. Necessary to avoid deformation of the vertebral discs and joints.
In an acute attack, novocaine blockade is prescribed (introduction of anesthetics directly into the affected area).
The symptoms of lumbar osteochondrosis in women manifest themselves differently than in men. In women, the menstrual cycle may be disturbed, as well as gynecological diseases may develop: inflammation of the ovaries and uterus (endometritis). Reproductive disorders 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 life.
The following treatment methods are used at home:
- Diet. Very often the cause of osteochondrosis is the build-up of cholesterol and the loss of vascular elasticity. In order to remedy the situation, it is necessary to adhere to a low fat diet. Also exclude foods high in cholesterol from the diet: eggs, pork, rich broths, chicken skin. Completely eliminate alcohol and nicotine, reduce the consumption of coffee and strong tea. They lead to vasospasm.
- Restoration of blood supply in the lumbar region. To do this, use both rubs with medicinal ointments and compresses, and physiotherapy exercises, which can be done at home.
- Orthopedic sleep aids. Since the spine is the axis of the human body, which undergoes enormous stress during the day, it needs a good rest. As such, orthopedic mattresses and pillows work, which are able to give the spine the correct position during sleep.