Osteochondrosis is a widespread disease of the spine that affects the intervertebral discs and cartilage. Cervical and lumbar regions are more susceptible to such processes. Osteochondrosis of the lumbar region can cause constant pain in the lower back and significantly complicate a person's life. In the treatment of the disease, priority is given to conservative methods, and surgical interventions are resorted to only in extreme cases.
Causes of lumbar osteochondrosis
Osteochondrosis is not so much a disease as it is often a natural phenomenon that occurs as a result of age-related degenerative changes in the spine. Normally, the disc in the lumbar spine acts as a shock absorber between the two vertebrae and allows the joints and spine to move easily. The outer part of the disc, the annulus fibrosus, surrounds the soft inner core of the disc, the nucleus pulposus. Everyone's spinal discs go through degenerative changes as they age, but not everyone develops symptoms.
It is believed that osteochondrosis begins with changes in the fibrous ring, intervertebral disc and subchondral bone. The annulus fibrosus loses water, which makes it less able to withstand the daily loads on the spine, misdistributing them. Overloading of the back part of the vertebra leads to arthritis of the facet joints and hypertrophy (growth with the formation of osteophytes - bony outgrowths) of the vertebral body next to the affected disc.
Reference! According to statistics, 30% of people between the ages of 30 and 50 have some degree of spinal disc degeneration.
There are two main pathophysiological causes of pain in lumbar osteochondrosis. One of the possible causes of pain is nerve inflammation as a result of rupture of the outer part of the disc and leakage of the inner core. Inflammatory proteins are released that irritate the nervous tissue.
According to another reason, the vertebrae, due to age-related deformation, are no longer able to effectively absorb the load. This causes the spine to move abnormally and causes painful spasms in the back muscles that try to stabilize the spine.
The outcome of osteochondrosis can be the destruction of spinal segments, which leads to radiculitis. Risk factors that trigger and accelerate degenerative processes in the spine are:
- Hereditary tendency to diseases of the musculoskeletal system;
- Smoking;
- Previous injuries;
- Hormonal and vascular disorders;
- Excess body weight;
- Muscles that are too weak and do not provide the necessary support to the spine;
- Professional activities associated with heavy physical work (athletes, loaders).
Stages of development of lumbar osteochondrosis
Disorders in the intervertebral discs, which lead to their degeneration and destruction, occur gradually. The entire pathological process goes through several stages, according to which the stages (or degrees) of lumbar osteochondrosis are distinguished:
- The first degree (degree) is characterized by mild symptoms. Painful sensations develop against the background of irritation of the nerve endings of the nucleus pulposus, penetrating into the fissures of the fibrous ring.
- The second stage is characterized by the movement of the upper vertebra in relation to the lower one, due to the rupture of the nucleus and annulus. These pathological processes, in addition to pain during movement, cause the appearance of neurological symptoms, a feeling of numbness and instability of the affected area.
- The third stage is characterized by an increase in pain and the appearance of herniated intervertebral discs, due to the violation of the integrity of the fibrous ring. Pain, sensory impairment, and muscle weakness interfere with daily tasks. Due to pinching of nerve roots, the functioning of the urinary and intestinal systems may be disturbed.
- The fourth stage corresponds to the complete destruction of the intervertebral discs, they become fibrotic, and the osteochondral growths of the vertebral bodies cause immobility of the spine in this part.
Symptoms of lumbar osteochondrosis
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- A neurologist
- Orthopedist
- Therapist
The main symptom of lumbar and sacral osteochondrosis is pain. It usually worsens when sitting for long periods of time, or when rotating, bending the spine, or lifting weights. The pain can spread to the leg, groin and be accompanied by a feeling of numbness and weakness. Moderate, aching, dull pain may be accompanied by bouts of exacerbation.
Symptoms directly depend on the stage of development of the pathology:
- In the early period, when degenerative changes are just appearing, the symptoms are minimal.
- The middle stage, characterized by the weakening of the fibrous ring, can already manifest itself as pain in the lower back.
- At a later stage, when fibrosis develops in the structures and osteophytes form, the pain becomes less pronounced, but the mobility of the spine is significantly reduced.
Lower back tenderness may increase when touched. Characteristic shooting pains in the buttocks, thighs and a tingling sensation are a sign of pinching of nerve roots that occur as a result of degenerative changes on the disc. Patients with lumbar osteochondrosis have difficulty bending forward, backward and sideways. Osteochondrosis can be complicated by disc herniation and narrowing of the spinal canal, followed by the appearance of additional symptoms.
Diagnosis of lumbar osteochondrosis
Establishing a diagnosis begins with collecting anamnesis, interviewing and examining the patient. The specialist will be interested in your complaints, physical activity, the presence of old injuries, bad habits and cases of illness in close relatives. During the physical exam, the doctor palpates (feels) the lower part of the spine, looking for tender areas, inflammation, or any abnormalities. He may also check sensation and perform motor tests.
The most popular method for diagnosing lumbar osteochondrosis is an X-ray examination. The image will show the presence of osteophytes, narrowing of the joint space of the disc or the so-called "vacuum" symptom, when gas bubbles are detected in the thickness of the disc. Other methods used are:
- MRI shows the hydration (degree of water saturation), the shape of the discs, their height, which enables the identification of pinched nerves.
- CT scan, which allows you to study the tissue condition in detail and diagnose disorders in the earliest stages.
- Provocative discography used to determine the location of the affected disc.
Reference! MRI is a fairly accurate diagnostic method, but it cannot detect rupture of the outer rings of the disc.
Methods of treatment of lumbar osteochondrosis
The preferred treatment for lumbar degenerative disc disease associated with chronic pain is conservative management with physical therapy, exercise, and medication. For patients with lumbar osteochondrosis, it is recommended:
- A daily routine that includes sufficient rest and adequate physical activity;
- Regular physical exercises aimed at strengthening muscles;
- Lifestyle adjustments, including dietary review and weight loss.
Physiotherapy
Various physiotherapeutic techniques have been successfully used to reduce low back pain. Physiotherapy encourages regenerative processes in the disc, stimulates metabolic and transport processes, prevents adhesions and further damage.
Physiotherapy methods used to treat osteochondrosis of the spine include:
- Electrical stimulation. Electrical impulses help relieve back pain and improve blood circulation in the affected spine.
- Ultrasound therapy. Ultrasound waves can penetrate deep tissue layers and help relieve inflammation and pain.
- Magnetotherapy. Magnetic fields can improve blood circulation and metabolic processes in tissues, promoting their regeneration.
- Laser therapy. Laser beams can help relieve pain, stimulate blood circulation and regenerate tissue.
- Ultraphonophoresis. This method combines ultrasound therapy with the use of drugs that penetrate deep tissue layers and help relieve inflammation and pain.
Important! Contrary to popular belief, osteochondrosis can and should be treated. Without treatment, it will become a source of chronic pain and can lead to numerous problems, including internal organ dysfunction.
Drug treatment
To relieve pain that interferes with daily activities, patients are prescribed analgesics and non-steroidal anti-inflammatory drugs. According to the indications, the doctor can also prescribe stronger drugs: muscle relaxants, steroids and narcotic painkillers. Therapeutic blocks are applied with local anesthetics and glucocorticoids to relieve intense pain.
Operation
Much less often, surgical intervention is used for osteochondrosis of the lumbar region. It may include disc arthroplasty or fusion of the lumbar spine (creating the conditions for the fusion of two vertebrae, while pain is reduced by eliminating movement in this part of the spine).
If the movement of the spine is significantly impaired, special intervertebral spacers can be implanted. For patients who do not respond to all other treatments, a total lumbar disc replacement can be performed.
Treatment of lumbar osteochondrosis at home
The most effective thing you can do at home to maintain functionality and control pain is exercise. They will increase the flow of blood, oxygen and nutrients to the spine, helping to keep the cartilage hydrated and the spine flexible for as long as possible. In addition, exercise releases endorphins, which are natural pain relievers.
Frequent changes of position also bring relief. Some poses help to deal with an attack of pain: kneeling, lying down, lying down. Short rest is necessary and beneficial, but prolonged rest only worsens the condition. It is important to stay active to prevent the disease from progressing. Patients with lumbar osteochondrosis benefit from walking, swimming, cycling, yoga, pilates, stretching exercises and strengthening the muscle corset. The following measures also help:
- Applying heat to the lower back improves blood circulation and relieves muscle spasms and tension.
- Ice packs will help relieve pain and reduce inflammation.
- Massage also relaxes muscles, relieves spasms and reduces pressure on the spine, thus relieving pain. By increasing blood circulation in this area, metabolic processes improve and tissues are enriched with oxygen.
- Use of orthopedic mattresses and pillows. They will help maintain the correct position of the spine during sleep.
- Proper distribution of the load on the spine. When lifting heavy objects, you should use proper lifting technique to avoid straining the lumbar spine.
- Proper nutrition. A balanced diet rich in calcium and vitamins will help maintain healthy bones and joints.
However, if you have pain or other symptoms, before starting the treatment of osteochondrosis at home, you should consult your doctor to get more precise recommendations and assess the condition of the spine.
Which doctor should I consult for lumbar osteochondrosis?
If symptoms characteristic of lumbar osteochondrosis appear, consultation with a neurologist or orthopedist is recommended. If you have lower back pain, you can also make an appointment with a therapist. He will prescribe the necessary tests to establish a diagnosis and refer you to a specialist.
Treatment of lumbar osteochondrosis
Specialists from the nearest clinic in your city or other place are ready to understand the reasons and help in dealing with the pain. Doctors usually have extensive clinical experience and master all modern methods of treating and diagnosing osteochondrosis in women and men. In general, a convenient location, excellent equipment and versatility of institutions are the priority of modern medicine, which allow you to quickly undergo any examination and restore the health of the musculoskeletal system. You can schedule an appointment by calling the clinic that suits you, as well as on the website by filling out an online form.
Prevention of lumbar osteochondrosis
Effective methods for the prevention of lumbar osteochondrosis are:
- Regular physical activity. Maintain good physical shape. Strengthen your back muscles. Stretching and strengthening exercises for the back will help keep your spine healthy.
- Reduce stress on the spine: Avoid unnecessary strain on the spine. Use proper lifting technique when lifting heavy objects.
- Posture correction: ensure proper posture. Sit and stand straight, don't slouch. Choose an orthopedic pillow and sleeping mattress to maintain the correct position of your spine while you rest. Buy quality shoes with good cushioning and support.
- Take care of back support by using orthopedic chairs if, due to the nature of your occupation, you are forced to sit for long periods of time. Avoid staying in one position for long periods of time. Take regular breaks and stretch your spine.
- Watch your weight. Excess weight can put additional strain on the spine.
- Avoid uncontrolled movements and back injuries. Be careful when doing sports or physical activity.
- Quit smoking, which can negatively affect the health of your spine.
By following simple recommendations, you can live an active and fulfilling life, minimizing the risk of back pain. If you already have symptoms, pain in the lumbar spine, be sure to consult a doctor for diagnosis and treatment.