Lumbar spine osteochondrosis is a pathological change in the cartilage and bone tissue of the intervertebral discs in the lumbosacral spine. This change can be natural or the result of an unhealthy lifestyle. In old age, the involutional processes of bone and cartilage tissue begin in all people. But when these phenomena are premature (they appear in middle-aged people), then we are talking about pathological processes of the skeletal system. The disease affects both men and women over the age of 30 equally.
Lumbar osteochondrosis is the most famous and common disease of the spine, which is manifested by severe pain in the lumbar region. The disease develops due to 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, so growths are formed in the form of osteophytes (growth of bone tissue, which leads to narrowing of the holes for nerve endings) 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, because the lower back carries the greatest load during walking and running, with prolonged sitting in a chair or lifting weights.
Since this anatomical site takes on the maximum load, its structure is very strong and reliable. The lumbar region consists of five vertebrae and connects the rib cage to the sacrum. Among them are the intervertebral discs, which give the spine flexibility and mobility. In turn, the intervertebral discs consist of a gelatinous core, which is located within a hard fibrous ring. When osteochondrosis develops, the normal nutrition of the discs is disrupted, 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.
Therefore, the reasons for the development of this pathology are:
- spinal injury;
- diseases of the endocrine, digestive and cardiovascular systems;
- strenuous physical activity (weight lifting, strenuous running);
- sedentary lifestyle;
- malfunctions of the hormonal system;
- flat feet;
- anomalies of the intervertebral discs;
- old age;
- inflammatory joint diseases, such as rheumatoid arthritis.
Risk factors for the development of the disease are:
- bending over and poor posture;
- wrong lifestyle;
- unhealthy diet, obesity;
- being in the wrong posture for a long time;
- hereditary factor;
- fatigue;
- 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 that radiates to the lower back;
- increased pain after lifting weights, sneezing, coughing, moving the body;
- stiffness of the body after being in one position for a long time;
- persistent spasms of the back muscles;
- sudden painful sensation (low back pain) after hypothermia of the body;
- violation of sensitivity in the buttocks, thigh, lower leg and foot;
- paresis in the legs;
- cold 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 turning the body to the side. In this case, the pain is noted not only in the lower back, but also in the legs. There is also a strong spasm of the lumbar spasm, as in this way the body relieves the load on this part of the body. During an exacerbation, a person finds a comfortable position for themselves in which the pain subsides.
One of the complications of osteochondrosis of the lumbar spine is a malfunction 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) can join the disease.
Stages of osteochondrosis of the lumbar spine
Unfortunately, osteochondrosis is an incurable disease, and the process of destroying the intervertebral discs is irreversible. There are four degrees of development of osteochondrosis:
- The first degree, in which the gelatinous core within 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 breaks down and the gelatinous core leaves it, which causes the formation of a herniated disc.
- The fourth degree is the period of development of the degenerative processes of the vertebrae with the involvement of the intervertebral joints and ligaments. Arthrosis of the intervertebral joints (spondyloarthrosis) 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 affected disc section. The pain can be acute, sharp or dull, is permanent and is localized in the lumbosacral segment. Very often it emits in the leg and is sometimes heard only in the leg.
Irritation of the nerve endings leads to the development of reflex syndromes. Because of this, a person does not always feel pain in the problem area, but far beyond it. In addition, there is a violation of robots of internal organs, the occurrence of reflex muscle spasms; circulatory disorders of the limbs and ligaments. Violation of blood circulation and nutrition of tendons and ligaments, which leads to pain and hardening in the places of attachment to the bones.
Second degree
At this stage, there is a characteristic instability and an increase in the mobility of the vertebrae, which leads to persistent lubrication of the muscles. At the same time, it is difficult for a person to stand upright, he feels discomfort and pain in the lower back. Sometimes the lower back "hurts" and the patient doesn't understand why.
Third grade
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 zone of innervation of the compressed nerve. In addition, there are unpleasant sensations in the form of tingling, burning, numbness and complete loss of sensation, which is accompanied by impaired motor function, which sometimes leads to paralysis. Muscle atrophy, thinning and reduction are observed in the affected area. The zones in which 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 Lasegue symptom. It manifests itself as follows: when the patient is lying on his back, with a straight leg, there is severe pain in the lumbar region, which spreads along the back of the raised leg. When the legs are bent at the knees, the pain disappears immediately.
When fragments of intervertebral discs fall into the lumen of the spinal canal, damage to the spinal cord occurs. Another syndrome, the so-called ponytail, is manifested by impaired sensitivity and motor function of the legs, as well as of 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 of the motor function. The spine, as it were, becomes woody as disc fibrosis develops and all of its elements are replaced by dense scar tissue. At the same time, the intervertebral ligaments and joints are involved in the inflammatory process, and different degrees of the disease are also observed, which are manifested by the 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, she will have to radically change his lifestyle and get rid of many daily habits, as well as work on his health for the rest of his life.
In the opposite case, even successful drug treatment will not be able to completely get rid of the deformity of the spine. Also, after a temporary improvement, the symptoms will return with a new intensity and the treatment will have to be restarted. Although sometimes, even with the observance of the regimen of physical activity, attacks of osteochondrosis occur.
Thus, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug treatment;
- not drug;
- surgery.
Conservative drug treatment
Since osteochondrosis of the spine cannot be completely cured and is an irreversible process, the goal of conservative treatment is to eliminate symptoms and prevent further progression of the disease. Before starting drug treatment, it is necessary to minimize physical activity. In case of severe exacerbations, bed rest is recommended. This is sometimes more effective than drugs.
To relieve the symptoms of inflammation, use:
- NSAIDs (non-steroidal anti-inflammatory drugs). Drugs of this group effectively eliminate pain and inflammation in the vertebrae. Medicines can be in pills or injections.
- Glucocorticosteroids. These drugs are classified as steroid hormones. Injections of glucocorticosteroids are given directly into the joint cavity. Without a doubt, they are supplemented with B vitamins (B1, B6, B12).
- Sedatives. They are necessary to eliminate 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 patient's mood improves, melancholy, anxiety and emotional stress disappear.
- Diuretic drugs. They are needed for signs of radicular syndrome.
- Anticholinesterase drugs. Drugs of this group inhibit the activity of the enzyme cholinesterase, as a result, the conduction of nerve impulses increases.
- Chondroprotector. Necessary to prevent deformation of the vertebral discs and joints.
In an acute attack, novocaine blockade (the introduction of anesthetic drugs directly into the affected area) is prescribed.
Symptoms of lumbar osteochondrosis in women manifest themselves differently than in men. In women, the menstrual cycle can be disturbed and gynecological diseases can develop: inflammation of the ovaries and uterus (endometritis). Reproductive damage can also occur. In this case, the help of a qualified gynecologist is needed.
How to treat lumbar osteochondrosis at home
The main principle of home treatment is to eliminate the symptoms that prevent a person from living a quality lifestyle.
The following methods of treatment are used at home:
- Diet. Most often the cause of osteochondrosis is the accumulation of cholesterol and the loss of vascular elasticity. To remedy the situation it is necessary to follow a low-fat diet. Also exclude from the diet foods rich in cholesterol: 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 rubbing with medicinal ointments and compresses, and physiotherapy exercises, which can be performed at home.
- Orthopedic sleep aids. Since the spine is the axis of the human body, subjected to enormous stresses during the day, it needs adequate rest. In this capacity orthopedic mattresses and pillows act, able to give the spine the correct position during sleep.