Pain in the back and lumbar region is one of the most common complaints in medicine.They occupy second place in terms of the number of requests, only surpassed by 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.Below we will analyze how to treat this disease, what symptoms and signs it has.
Not so long ago, medical science believed that osteochondrosis in the lumbosacral region occurs solely due to age-related changes that cause wear of the vertebrae and intervertebral discs.However, today the symptom of age is not exclusive;Osteochondrosis of the lumbar spine is diagnosed in patients of different age groups.Today it is considered that the cut-off age is greater than 25 years.
Causes of lumbar osteochondrosis.
It is impossible to name the exact reason;It will almost always be the complex impact of several destructive factors, among which the most important can be identified:
- Commitment to a passive lifestyle.from the point of view of motor activity.By their own will, immobilized people, for example, who spend many hours at a computer, do not receive enough payload, so the "corset" muscles relax and the load on the vertebrae increases.In addition, this hobby is almost always associated with prolonged exposure to incorrect and unnatural positions.
- Problems with hormonal levels., which leads 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 anomalies.when 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 loads.in the lower back.In this case, the risks include people with certain types of professional activities, usually associated with lifting heavy objects.This also includes professional athletes who constantly subject their body to maximum loads.
- Altered food intake and daily routine..This also includes regular exposure to stress.These factors affect metabolic processes and influence the periodic recovery of the body's 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 first or causing pain that is difficult to tolerate during late 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 disc is located.The pain may be sharp with stabbing or constant 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 in this area tense, which ultimately leads to chronic fatigue in the lower back.
- Next, a rupture occurs in the annulus fibrosus, causing the nucleus to leak beyond the edge of the disc, forming an intervertebral hernia.This 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.Mobility problems appear, but the pain syndrome, interestingly, at this stage subsides.However, you should not rejoice;This does not mean that the disease is disappearing.
- The last degree is characterized by pathological growth of bone tissue and general deterioration in health.
Depending on the degree of lumbar osteochondrosis, certain treatment methods are used.
Symptoms of osteochondrosis in the lumbar area.
The main symptom is combat 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 due to the fact that, depending on the degree of damage to the intervertebral disc and surrounding tissues, certain nerve receptors become irritated.Additionally, the presence of a bulge or the hernia itself, the direction of its bulge, and many other factors influence it.
The main symptoms of osteochondrosis of the lumbar spine include:
- The presence of painful pain in the lower back, which tends to intensify with sudden movements or, on the contrary, by remaining for a long time without changing position.The pain disappears if you adopt a horizontal position.
- Additionally, weakness in the area of the body below the abdomen, including the lower extremities, as well as a blunted tendon reflex in the legs are likely to occur.
- 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, we talk about scoliosis, lordosis is the situation of forward bending, and kyphosis is the case when the natural lumbar curve is, so to speak, softened.
- With a severe degree of development of the disease, it is possible to pinch the spinal cord canals, which can lead to their dysfunction and lead to uncontrolled urination and feces.
Additional symptoms include:
- The presence of numbness and “coldness” of the skin of the lower back and buttocks.
- Flaky, dry, bluish skin in the same places.
- Problems urinating.
- Erection problems.
The presence of these symptoms should alert the person;You don't have to give them up, this will only lead to further abandonment.In this case, you should definitely consult a doctor for accurate diagnosis and treatment.By the way, the treatment can be done in a hospital or at home, but we will talk about that a little later.
Diagnosis of the disease.
When making a diagnosis, it is important to understand to what extent the disease has progressed.The simplest way is palpation in the lumbar region to identify areas of pain.Normally, this method is not very informative and tests are also performed that give a more detailed clinical picture:
- by x-ray, an economical and widespread method, allows evaluating the condition of both the spine as a whole and individual vertebrae, for example the lumbar region in question.The technique is not very precise;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 imagingIt is the most accurate method and provides a complete picture of the injury in detail, but it 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 protuberances, which inevitably arise if treatment is neglected and the development of the disease is left to chance.Other complications may include:
- Inflammation of the sciatic nerve.
- Spondylarthrosis.
- Schmorl's hernia.
- Spondylosis.
- Problems caused by pinching of the 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 therapy is required, the main aspects of which will be:
- Application of moderate loads.
- Special medications.
- Traction of the spine.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massages.
The concept of "treatment" of osteochondrosis implies:
- Suppression of inflammation.
- Relieve pain syndrome.
- Complex to strengthen the lumbar and adjacent muscle groups.
- Relief of chronic muscle tension.
- Increase the functionality of the pelvic organs.
- Normalization of blood circulation and metabolism in the pathological area.
Drug treatment
A similar approach to the treatment of lumbar osteochondrosis includes taking medications, injections of special medications, and the use of ointments and gels for external use.The main task of these 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 medications:
- Analgesics that have an analgesic effect.
- Medications 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 previous remedies do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these medications, medications in tablets 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 taking pills.The pathology in question cannot be cured without stimulating the restoration processes of the spine.For these purposes, a wide range of physiotherapy procedures is used, the most popular of which are:
- Phonophoresis.
- Therapy with diadynamic currents.
- Laser therapy.
In addition, it is necessary to apply useful loads to the spine and at the same time stretch it.Various types of therapeutic massages 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, the muscles overloaded by the disease are well relaxed;Its effect will increase significantly when heated simultaneously, for example in a bathhouse or sauna.In the latter case, we will achieve the maximum effect thanks to the additional stimulation of blood circulation in the area of pathology 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 these techniques, the specialist manages to return the 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 disappeared.The key to the high effectiveness of therapeutic exercises is their regularity;In this case, the damaged area will constantly receive the physical activity necessary for the self-generation of new tissue and its recovery.
Surgical operations for lumbar osteochondrosis.
Surgery is the last resort, which is prescribed in case of serious complications.The most common of them 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 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.