Lumbar osteochondrosis: causes, symptoms, diagnosis, treatment

Lumbar osteochondrosis is a dangerous spinal disease characteristic of people who have reached the age of 35 and over. Natural wear of the joints provokes the development of pathology. Premature access to a rheumatologist, in most cases, leads to disability. Modern medicine offers many effective methods of treatment in the primary stages. Early diagnosis is the key to an unrestricted healthy life.

Lumbar osteochondrosis - general definition

Osteochondrosis of the lumbar spine is a process of dystrophic degeneration in the formations of the intervertebral cartilage - discs.

The discs provide the main functions of the spine: the ability to move and bend, resistance to stress. As a result of the pathology, important elements thin, deform, the vertebrae are aligned, nerve endings and blood vessels are pinched. Negative processes are accompanied by pain sensations of varying intensity and limitation of motor function.

Pathology causes changes in the connecting elements of the spine: cartilage, bones, discs and joints. It is caused both by natural processes of wear and tear, and by acquired diseases of the joints or the result of an improper lifestyle.

Causes

There can be many reasons for the development of lumbar osteochondrosis:

• Natural or premature wear of the body;
• Excessive load on the lower back - lifting of loads, "standing" work or a sedentary and "sedentary" lifestyle;
• Genetic predisposition to joint diseases, such as rheumatoid arthritis
• Violation of metabolism, resulting in the accumulation of toxic substances in the connecting discs;
• Chronic diseases of the circulatory system. Nutrients and trace elements cease to enter the cartilage tissue in the right amount. Hypoxia arises, which contributes to the destruction of the intervertebral joints;
• Autoimmune diseases.

Secondary factors can also provoke the development of lumbar osteochondrosis:

• Chronic injuries, back bruises;
• Exceeding the weight norm by more than 15-20%;
• Heavy or power sports;
• Constantly wearing uncomfortable shoes. High heels, narrow shoes, rubber or sports shoes are the first enemies of the spine;
• Valgus changes in the foot
• Scoliosis, kyphosis, diabetes mellitus, spinal tuberculosis;
• Impact of low temperatures.

Clinical picture

Symptoms of lumbar osteochondrosis completely depend on which nerve roots are affected by the disease. The degree of compression of the vertebrae, the stage of the disease and the damage to the disc determine the signs.

Rheumatologists distinguish the following main symptoms:

• Violation of tactile susceptibility in the lumbar region. Numbness extends to the inside of the thighs and groin. It can affect one or both limbs;
• There is a sharp, stabbing pain in the lower back. The big toe completely loses mobility and a characteristic numbness is observed;
• Loss of normal foot function, sensation in the toes, lower leg and outer thigh. In these parts of the leg there is a tone and regular seizures. On examination, there is no Achilles reflex;
• If the disease affects the lower radicular artery, then there is complete paralysis of the muscles of the buttocks, back of the thighs and perineum. There is a serious violation of motor function, up to complete immobility.

With lumbar osteochondrosis, not only the nerve endings of the spine are affected, but also the blood vessels.

The following specific signs depend on the type of injury:

• When only the nerve roots are disturbed, a change in the patient's gait is observed. The pain is localized not only in the lower back, but also in all parts of the legs. Radicular syndrome is characterized by constant pain. Usually only on one side. In the lower back, tingling and pain are noted. The pain can be relieved with a little exercise.
• Compression of blood vessels leads to perfusion in the hip area. As a result, oxygen starvation of the spinal discs occurs. Painful sensations occur while walking in the buttocks, thighs and lower back. Completely removed after a restful night.

Simultaneous violation of the functionality of blood vessels and nerve roots can lead to irreversible deformation of the discs. Spine-shaped bony growths form in the movable joints of the lower back. This leads to severe pain and makes normal natural movement impossible. Violated posture, gait. As it progresses, complete paralysis can occur.

Stages of the disease

Lumbar osteochondrosis develops gradually, in several stages. Each stage has its own characteristics, which determine the degree of progress.

• me on stage.The slow destruction of the intervertebral discs begins. The process can take anywhere from several months to 2-5 years. Manifested by minor pain, discomfort in the groin and femoral muscles. It is noticeable when walking or when the weather changes.
• II stage. The collagen fibers of the fibrous rings of the spine are attracted in the negative process. The space between the individual vertebrae is rapidly shrinking. Friction appears, which causes severe pain attacks. It appears gait, posture, bending over violated. Lumbar osteochondrosis is often diagnosed in the second stage of the course.
• III stage.An intervertebral hernia appears. And if the patient has not been forced to seek medical help with stage II symptoms, it will no longer be possible to ignore the excruciating pain of the third stage. The deformation of the bones and joints of the spine in the lower back is already irreversible. Walking takes a lot of effort. This is due to the pain and the inability to relieve it with conventional pain relievers.
• IV stage.Partial or complete impairment of motor function. At this stage, the patient is assigned a disability group. Threatening with complete paralysis. Vital activity is impossible without taking a wide range of medicines.

Diagnostic measures

Diagnostic measures include several techniques and begin with the collection of a complete history of the disease. During the initial consultation with a rheumatologist, the following facts are clarified:

1. The patient's complaints are carefully analyzed: the place of localization of pain, where discomfort is still felt, in which parts of the hip joint there is a feeling of heaviness, convulsions, etc. ;
2. Duration, regularity, nature of the pain;
3. When the first, even mild, symptoms appeared. How much time has passed since the last attack, what causes discomfort and what factors contribute to its elimination;
4. Surrounding living conditions of the patient. Profession, work, household load, sports and the presence of additional factors for increased physical activity (dacha, garden, hobbies associated with the transfer of weights);
5. Examination of the history of diseases that the patient has suffered in the past or in the present.

Having collected the clinical picture, the rheumatologist proceeds directly to the external examination. During the examination the gait is analyzed, the anatomical position of the legs, arms, torso, in relation to the vertebral column. The skin is examined for changes: pigmentation, peeling, eczema, rashes, etc. An assessment of motor function is provided.

By performing simple exercises: tilting forward, backward, lifting arms and legs, turning the head, rotating movements of the pelvis, the patient allows the doctor to determine the degree of damage to the spine in the lumbar region.

The final measures of the external examination are actions to determine the degree of root damage:

• Symptom Lasegue.Lying on his back, the patient alternately raises his legs, bent at the knee. If this causes pain in the lower back, the readings are considered positive.
• Dejerine symptom.The patient is asked to tighten the abdominal muscles as much as possible. The occurrence of discomfort in the spine indicates the development of lumbar osteochondrosis.
• Symptom Blacks. Strong tilting of the head forward and backward responds with pain in the lower back.
• Wassermann symptom. The patient, in the supine position, moves the leg to the side as far as possible. In the presence of pathology, unpleasant pain occurs in the groin and in the front of the thigh.

To confirm or exclude the diagnosis, the patient is asked to undergo instrumental diagnosis. MRI is considered the most effective way to determine lumbar osteochondrosis. The study shows the distance between the vertebrae, the development of neoplasms and bone deformities. It can be contraindicated in patients with mental disorders.
Computed tomography provides a fairly true picture of the disease in one plane: horizontal or vertical.
X-rays are used only in the last stages, when irreversible changes in the bone tissue of the spine begin.

Complex treatment of lumbar osteochondrosis

The causes of the disease have not been fully clarified. Scientific research in the field of joint diseases of the spine has not yet identified sufficiently effective methods for the complete restoration of intervertebral discs. Modern methods of treatment are aimed only at eliminating the external signs of the disease. Full recovery is currently considered impossible.

Traditional drug therapy

The rheumatologist prescribes drugs, depending on the general condition of the patient. The clinical picture provides the information necessary to draw up a treatment regimen with drugs from different groups.

1. Anesthetic agents.Injections, ointments or broad-spectrum drugs are prescribed.
2. Anti-inflammatory drugs (NSAIDs).
3. Vasodilators.Removal of tone from the muscles of the lower back and legs.
4. Chondroprotectors.Designed to rule out the negative progress of lumbar osteochondrosis.

Physiotherapy

Physiotherapy procedures are an integral part of inpatient or outpatient treatment of lumbar osteochondrosis.

It includes the following activities:

• Electrophoresis with painkillers;
• Magnetotherapy;
• Hydrotherapy;
• Paraffin applications.

Medicines and physiotherapy on the whole relieve acute pain and inflammation. But they are not a guarantee to stop the progress of the disease. Only a course of treatment 2-3 times a year and a responsible attitude of the patient will help to avoid regression and keep the general condition in a satisfactory form.

Physical therapy and therapeutic massage

A set of therapeutic gymnastics exercises ensures the normalization of blood circulation in the lower back and helps to eliminate stagnant processes. Only a physiotherapist can prescribe exercises for clinical or home use. As a rule, these are all kinds of soft inclinations and rotational movements, from a prone and sitting position. Independent physical activity not only cannot lead to results, but can cause even greater displacement of the vertebral discs.

Manual therapy sessions help strengthen muscle tissue, blood flow to the affected lower back, and relieve tension. The specialist performs the massage first on a healthy part of the back, to warm up the muscles and improve blood circulation. Then it goes to the affected areas of the lower back. The manipulation area includes the lower back, buttocks, thighs, shins and feet. Sessions take place in regular courses, at least 10 sessions in 6 months.

Surgery

It is indicated in the last stage of lumbar osteochondrosis, in order to restore the motor function of the spine. Surgery remains the only option for patients presenting with the following symptoms:

• Constant pain syndrome, not amenable to treatment even with opiate-containing drugs;
• Strong compression of the nerve roots and noticeable displacement of the discs;
• Neoplasms, proliferation of bone tissue;
• Complete destruction of the vertebrae, due to constant friction;
• Paralysis.

Modern methods offer less traumatic methods of internal intervention. For example, endoscopy. It has a favorable prognosis, a short rehabilitation period and a low rate of side effects.

Alternative treatment

Lumbar osteochondrosis responds well to treatment with medicinal herbs and folk methods. Paid ointments, tinctures, baths are used to relieve swelling and pain. The most effective recipes include anesthetic and anti-inflammatory herbs:

• yarrow;
• Aloe;
• Peppermint;
• St. John's wort;
• Fir or pine needles;
• Wise.

The content of these herbs in folk recipes is due to their medicinal effects, scientifically proven by traditional medicine. Treatment at home will help keep the lower back in a stable condition and prevent exacerbation of the disease after complex treatment.

Prevention

Despite the fact that lumbar osteochondrosis is an incurable disease, its negative manifestations can be minimized. In the early stages, the disease is successfully treated, it is only necessary to seek medical help in a timely manner. It is important to fully adhere to the drawn up treatment regimen and follow the recommendations of the rheumatologist.