What is lumbar osteochondrosis

Osteochondrosis in the lumbar region occurs due to the deformation and destruction of cartilage tissue of the intervertebral disc.Without cartilage, the vertebrae lose their elasticity and become displaced, causing pain.According to WHO, this disease mostly attacks people over 30 years old.Women get sick three times more often, which is also associated with age-related changes and a decrease in the level of calcium in the body.

Osteochondrosis of the lower back

Of all diseases of the peripheral nervous system, osteochondrosis of the spine accounts for 80%, of which 60-80% affects the lumbar region, which consists of 5 vertebrae.In 40% of people, the first signs of the disease appear at the age of 30-35 years.In old age, osteochondrosis of the spine is diagnosed in 90% of people.Painful sensations are experienced by 7 out of 10 people, exacerbations can last from 6 to 16 months.

Stage of development

• First - the onset of degenerative disorders, affecting nerve endings and disrupting blood supply.The inflammatory process causes pain that radiates to the leg.The patient experiences occasional tingling in the back and buttocks.Appears after heavy physical exercise.
• 2nd - the outer skin of the intervertebral disc (fibrous ring) is destroyed.The distance between the vertebrae is reduced, the nerve endings are compressed, which causes severe and acute pain.Symptoms are mainly expressed while walking.
• Third - due to excessive vertebral mobility, muscle fibers and nerve endings are compressed.Cramps, numbness, burning pain, hernia occurs - displacement of the intervertebral disc into the spinal cord.
• 4th - the growth of pathological exostoses on bone structures.The spine literally "turns to stone."Progressive arthrosis and lack of treatment cripples the patient.

Because of development

The disease develops slowly, under the confluence of several conditions, that is, the development of the disease depends on the influence of not one, but several factors:

• Sedentary lifestyle (physical inactivity), sedentary work, low level of physical activity.At first glance, they are harmless.However, with prolonged exposure, muscle tone, called "muscle corset," becomes weak.It supports the spine and internal organs.Therefore, physical inactivity causes disturbances in the functioning of several systems - blood circulation, breathing, digestion.
• Excess body weight.With a BMI (Quetelet's body mass index) above 25 kg/m2, excess body weight puts additional stress on the body: it puts pressure on the spine, strains the joints and affects the blood supply.
• Endocrine pathological process.Hormonal imbalances, disturbances in the functioning of the adrenal glands and the thyroid gland "slow down" the body's metabolism.Frequent hormonal changes "wash" calcium from bone tissue, making it weak and brittle.
• Unbalanced diet.Popular and affordable fast food fully meets the body's energy needs, while from the point of view of saturating the body with the necessary vitamins and microelements, it is completely useless.
• Pathology and genetic predisposition to diseases of the musculoskeletal system.
• Degenerative age-related changes.Under the influence of time, natural wear and tear of the support system occurs.

In men whose profession involves significant physical activity, lumbar osteochondrosis occurs many times more often.

Symptoms of lumbar osteochondrosis

Pain is the main marker of the onset of the disease and its localization.Based on the nature of the event, frequency and duration, a preliminary diagnosis can be made.Often, patients with lumbar osteochondrosis experience pain that radiates to the legs, groin area, and tailbone.In a horizontal position, the discomfort disappears.

Spinal nerves extend from the spinal cord to different parts of the body.Each nerve is responsible for a specific area.This is called "segmental innervation."It is for this reason that the affected nerve "reacts" in a certain area: this is how "radicular syndrome" manifests itself.

The spinal nerve map allows you to identify pain with specific regions of the spine: C1-C8 - 8 cervical, T1-T12 - 12 thoracic, L1-L5 - 5 lumbar, S1-S5 - 5 sacral, C0 - 2 coccygeal.Signs of osteochondrosis depend on the preservation of segments:

• L3-L4 - weak knee reflex, partial numbness, episodic loss of sensation noted along the anterior surface of the thigh;
• L4-L5 – muscle weakness, the patient cannot correct the body while standing on the heels, pain and sensitivity disturbances extend to the area from the lower back to the back, as well as along the lateral surface of the entire thigh (from top to bottom).
• L5–S1 – tremors in the calf muscles, inability to stand on toes, pain in the back of the thigh.

In rare cases, the radicular artery is also involved in the destructive process, giving rise to a spinal stroke - a dangerous pathology in which the patient experiences paresis and paralysis, and pelvic organ dysfunction.

Pain reflex symptoms

• Lumbago or lumbago (in this case not sciatica!) – acute pain.Any awkward movement, even sneezing and coughing, causes spasms.The patient spontaneously changes the position of his body, moving it to the side.An attempt to take a vertical position gives rise to a new lumbago.
• Lumbodynia is a dull, aching pain that occurs on one side.A period of remission is followed by an exacerbation, which gradually develops into severe pain.
• Lumboischialgia - painful sensations appear in the legs.

The side effects of this disease are not very typical and can easily be mistaken for symptoms of other problems: impaired sweating (hypohidrosis), pale skin in the affected area due to poor blood circulation, severe dryness and peeling.

Diagnostics

At the initial stage, a complete medical history of the patient is collected.The overview should be supplemented with the opinion of surgeons, orthopedists, neurologists, and rheumatologists.The specialist is subjected to a visual examination of the patient to assess changes in posture, muscle tone and skin sensitivity.

X-ray is carried out for the primary diagnosis of lumbar osteochondrosis of the 1st degree;it is used to check the condition of the intervertebral disc, pathology of the spinal cord, and also evaluate the general condition of the spine.However, this type of diagnosis does not provide complete information about the affected tissue.

Computed tomography (CT) is a very sensitive examination using ionizing radiation.CT scans record the degree of disc deformation, inflammatory processes in the spinal cord membrane and nerve endings in a layer-by-layer image.

Magnetic resonance imaging (MRI) informatively shows the general condition of muscle mass, blood vessels, and ligaments.Detect tumors and inflammatory processes.

Myelography is one way to visually assess the condition of the spinal cord and nerve roots by injecting a contrast agent using a needle into the cavity between the pia mater and the arachnoid of the spinal cord, which is filled with cerebrospinal fluid.Just like CT, MTP and X-ray, the procedure is carried out in real time.

Neurological examination of sensitivity and reflexes for pathology is a complex study that includes examination methods to study limb symmetry, test vibration sensitivity, and assess Babinsky, Chaddock and Oppenheimer reflexes.

Treatment of lumbar osteochondrosis

The effectiveness of conservative treatment is achieved through a combination of drugs of various groups, massage and manual therapy.However, at stage 3, lumbar osteochondrosis can no longer be cured using conservative methods;surgical intervention is required.One of the surgical methods for osteochondrosis is microdiscectomy.This is a neurosurgery to remove the hernia without damaging the nerve structure.It is performed under general anesthesia.The patient can already walk on the 3rd day.

Drug therapy (for stages 1-2)

• Analgesics for pain relief: local (ointment, gel), oral (tablet, suspension), intramuscular (injection solution).
• Non-steroidal anti-inflammatory drugs to prevent the development of the inflammatory process.Reduces temperature, eliminates swelling.Most often, gels and tablets are used, in more serious cases (inflammation of the sciatic nerve) - injections.Prime course - 7-14 days.
• Relax the muscles.Prescribed in the acute period for muscle spasms, as well as during the remission period to consolidate the effect.
• Chondroprotectors.Blocks destructive processes in intervertebral discs, promotes regeneration, improves metabolism in cartilage tissue.
• Vascular medicine.Helps normalize blood supply to the musculoskeletal system.
• B group vitamin complex. Improves nerve conduction.
• Diuretic.Reduces swelling.

As an emergency aid at the time of exacerbation, strong injections are used - paravertebral blockade, which causes a temporary loss of sensitivity.

It is also recommended to undergo a course of manual therapy twice a year, which relieves muscle tension and spasms, restores blood circulation, improves lymph circulation, and improves the mobility of the musculoskeletal system.

Prevention

• An active lifestyle combined with moderate physical activity;
• Choose comfortable orthopedic shoes or, if indicated;
• Good nutrition;
• Weight control;
• Sleep only on orthopedic mattresses and pillows;
• Office furniture only with a flat back;
• Rejection of heavy loads on the back and spine.When carrying heavy objects, the load should be distributed evenly on both hands.