Lumbar osteochondrosis: causes, symptoms, diagnosis, treatment.

Lumbar osteochondrosis is a dangerous disease of the spine, characteristic of people who have reached the age of 35 years and older. The natural wear of the joints causes the development of pathology. Untimely 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 a healthy and unrestricted life.

Lumbar osteochondrosis - general definition

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

The discs provide the main functions of the spine: the ability to move and bend, resistance to stress. As a result of pathology, important elements are thinned, deformed, 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 produced both by natural processes of wear and tear, as well as by acquired diseases of the joints or as a result of an inadequate 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 loads, working "standing" or a sedentary lifestyle, "sedentary";
• 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 proper amount. Hypoxia is established, which contributes to the destruction of intervertebral joints;
• autoimmune pathologies.

Secondary factors can also provoke the development of lumbar osteochondrosis:

• Chronic injuries, back bruises;
• Exceed the weight norm by more than 15-20%;
• Heavy or power sports;
• Constantly wearing uncomfortable shoes. High heels, tight 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

The symptoms of lumbar osteochondrosis depend entirely on the nerve roots 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. The numbness spreads to the inner thighs and groin. It can affect one or both extremities;
• 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 function of the foot, sensation of the toes, lower leg, and outer thigh. In these parts of the leg, there is a tone and regular convulsive attacks. On exam, there is no Achilles reflex;
• If the disease affects the lower radicular artery, then there is complete paralysis of the muscles of the buttocks, the back of the thighs, and the 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.
• The compression of the blood vessels leads to perfusion in the hip area. As a result, oxygen starvation of the spinal discs occurs. Painful sensations occur when walking in the buttocks, thighs and lower back. Completely removed after a night's rest.

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

disease stages

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

• I stage.Slow destruction of intervertebral discs begins. The process can last from several months to 2-5 years. It is manifested by mild pain, discomfort in the inguinal and femoral muscles. It is noticeable when walking or when the weather changes.
• II stage.Collagen fibers from the fibrous rings of the spinal column enter the negative process. The space between the individual vertebrae is rapidly shrinking. Friction appears, which provokes strong attacks of pain. Violated gait, posture, appears hunched over. Lumbar osteochondrosis is most often diagnosed at the second stage of the course.
• III stage.An intervertebral hernia appears. And if the patient was not forced to seek medical help with the symptoms of stage II, it will no longer be possible to ignore the excruciating pains of the third stage. The deformation of the bones and joints of the spine in the lower back is already irreversible. Walking requires a lot of effort. This is due to the pain and the impossibility of relieving it with conventional analgesics.
• IV stage.Partial or total alteration of motor function. At this stage, the patient is assigned a disability group. Threaten with complete paralysis. Vital activity is impossible without taking a wide range of drugs.

diagnostic measures

Diagnostic measures include various techniques and begin with the collection of a complete history of the disease. During the initial consultation with a rheumatologist, the following data 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 symptoms appeared, even minor. How much time has passed since the last attack, what causes discomfort and what factors contribute to its elimination;
4. Living conditions of the patient's environment. Profession, work, household load, sports, and the presence of additional factors to increase physical activity (country house, 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.

After collecting the clinical picture, the rheumatologist proceeds directly to the external examination. During the examination, the gait, the anatomical position of the legs, arms, torso, in relation to the spine are analyzed. The skin is examined for changes: pigmentation, scaling, eczema, rashes, etc. An assessment of motor function is given.

Performing simple exercises: leaning forward, backward, raising arms and legs, turning the head, rotational 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:

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

To confirm or exclude the diagnosis, the patient is invited 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. May be contraindicated in patients with mental disorders.
Computed tomography gives a fairly true picture of the disease in one plane: horizontal or vertical.
Radiography is used only in the later stages, when irreversible changes in the bone tissue of the spine begin.

Complex treatment of lumbar osteochondrosis.

The causes of the pathology have not been fully elucidated. Scientific research in the field of spinal joint diseases 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. Currently, full recovery is considered impossible.

Traditional drug therapy

The rheumatologist prescribes medications, depending on the general condition of the patient. The clinical picture provides the necessary information for drawing up a treatment regimen with drugs of various groups.

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

Physiotherapy

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

Includes the following activities:

• Electrophoresis with analgesics;
• magnet therapy;
• hydrotherapy;
• paraffin applications.

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

Exercise 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 physical therapist can prescribe exercises for clinical or home use. As a rule, these are all kinds of gentle tilts and rotational movements, from a prone and sitting position. Independent physical activity may not only not bring any results, but can cause even more 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 massages 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. The sessions are held in regular courses, minimum 10 sessions in 6 months.

Surgical intervention

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

• Constant pain syndrome, not amenable to treatment even with drugs containing opiates;
• Strong compression of the nerve roots and significant 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. Fee-based ointments, tinctures, baths are used to relieve swelling and pain. The most effective recipes include anesthetic and anti-inflammatory herbs:

• yarrow;
• Aloe;
• Mint;
• Grass of San Juan;
• fir or pine needles;
• Wise.

The content of these herbs in popular recipes is due to their medicinal effects, scientifically proven by traditional medicine. Home treatment will help keep the lower back in a stable condition and prevent the 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 comply with the elaborated treatment regimen and follow the recommendations of the rheumatologist.