Osteochondrosis of the lumbar spine

One of the most common diseases today isosteochondrosis of the lumbar spine. Men and women turn to doctors with this disease with equal frequency.

At least once in our lives, each of us has felt pain in the lower back, sacrum or lower extremities. We often unknowingly call this type of pain "pinched nerve in the lower back. "

Causes of lumbar osteochondrosis

According to research by doctors and scientists, the main cause of osteochondrosis of the lumbar spine is an upright posture. However, not everyone suffers from osteochondrosis. The provoking factors that accelerate the development of the disease are: metabolic disorders, physical inactivity, injuries, excess weight, inappropriate weight lifting.

The source of pain in osteochondrosis is pinched nerve roots, which occurs after protrusion of the intervertebral disc and narrowing of the intervertebral space. This deviation is formed when nutrition deteriorates, the natural processes of oxygen and lymph exchange in the tissues of the intervertebral discs are disrupted. As a result, the shock-absorbing capacity of the intervertebral discs decreases and the nucleus pulposus of the disc gradually shrinks and dries out.

From an anatomical point of view, lumbar osteochondrosis is a process of transformation of cartilage into bone, resulting in excessive pressure on the nerve roots that extend from the spinal cord. This change causes pain. Excessive growth of bone tissue occurs due to deterioration of nutrition of the intervertebral discs, loss of fluid and disturbances in structure and function.

When the protrusion of the intervertebral disc during the development of osteochondrosis of the lumbar spine becomes more severe, it provokes the development of lumbar protrusion and lumbar disc herniation due to rupture of the fibrous ring.

Pain syndrome is formed due to compression of the spinal nerve in lumbar osteochondrosis and is called lumboischialgia. This symptom is accompanied by numbness in the lower extremities. Depending on the nature and location of the pain, the disease can be divided into sciatica and low back pain. Inflammation of a nerve due to its compression is called radiculitis. Methods of treating radiculitis with analgesics, in fact, are only the elimination of symptoms, and are ineffective, because such treatment does not affect the true cause of the disease, namely the degenerative processes in the intervertebral discs. To eliminate pain and take preventive measures to prevent complications, it is necessary to undergo comprehensive treatment to activate restorative processes in the disc tissues, normalize the height and physiological parameters of the intervertebral discs.

Symptoms of osteochondrosis of the lumbar spine

One of the signs of osteochondrosis is compression of the spinal nerve roots by the protruding nucleus pulposus of the intervertebral disc. This compression occurs in the epidural space, which is a kind of container for the spinal roots. Osteochondrosis of the lumbar spine is manifested by the following symptoms that correspond to a compressed root:

• L1 and L2 – loss of sensitivity in the "knight's pants" area, namely in the groin area and inner thighs. Pain can occur in both legs at the same time if lumbar osteochondrosis is complicated by the development of a hernia.
• L5 – acute pain, decreased sensitivity in the lower back and sensitivity in the thumb, as well as decreased ability to flex the finger.
• S1 – sharp pain, decreased sensitivity in the leg and outer part of the thigh, pain in the foot from the little toe to the fourth toe. Often, when this root is damaged, the Achilles tendon and plantar reflexes are lost.
• Damage to the Deproge-Gotteron artery - in the chronic course of osteochondrosis, paralysis of the leg and buttocks may occur, and sensitivity may disappear in the anogenital area.
• Simultaneous damage to the L5, S roots and the Deproge-Gotteron artery causes "paralyzing sciatica" syndrome, loss of pelvic and motor functions.

Osteochondrosis of the lumbar spine can cause protrusions and hernias due to significant loads on this part of the spine. It is these complications that develop very quickly, so it is very important to treat them in a timely manner. Do not delay the visit to the vertebrologist, undergo a complete examination and seek qualified help at the first symptoms of lumbar osteochondrosis.

Complications of osteochondrosis of the lumbar spine

Compression vascular ischemia can be considered a complication of lumbar osteochondrosis. This pathology develops due to impaired blood supply to the spinal cord, reduction of intervertebral openings for vessels and arteries, as well as narrowing of the peripheral structures of the vertebrae. The reason for the development of this pathology is the flattening of the discs, excessive mobility of the spine, weakening of the ligaments, formation of osteophytes and neoatrosis. Permanent injury and pressure on a compressed vessel or artery occurs due to any movement of the spine that affects the damaged area. In addition, a reflex narrowing of the vessel passing through the pinched opening of the channel may occur. This effect is called "narrow bed".

Vertebrologists identify another serious complication of osteochondrosis of the lumbar spine. Compressive myelopathy is a spinal cord disorder that occurs due to narrowing of the spinal canal. Depending on the location, the symptoms and severity of the pathology may vary. Most often, the course of the disease is characterized by episodicity - after an attack there is a period of remission.

Lumbar osteochondrosis can be complicated by a herniated TXII-L1 disc, which puts pressure on and causes damage to the S1-S2, L2-L-4 segments of the spinal cord. A patient with this complication feels pain in the lower back, leg, back of the thigh, as well as weakness in the legs. The gluteal and calf muscles gradually become hypotonic and hypotrophic, the Achilles and plantar reflexes fall, and paresis of the foot forms. The back and outer surfaces of the foot and leg are characterized by reduced sensitivity or complete absence.

If a LI-II disc herniation occurs, in which excessive pressure increases in the S3 coccygeal segment, osteochondrosis of the lumbar spine has the following symptoms: rupture of the pelvic organs, fecal and urinary incontinence, constipation, loss or decrease in sensitivity of the area anogenital, development of bedsores, anal prolapse reflex.

"Cauda equina syndrome" develops when nerve roots are compressed from the first lumbar vertebra and below. An experienced vertebrologist notes that this syndrome most often develops in patients with congenital narrowness of the spinal canal. The "cauda equina" is a bundle of nerve roots that contains the terminal roots of the spinal cord from the first segment. The name arose from its resemblance to a horse's tail. The diagnosis of this syndrome largely depends on the presence of excruciating pain of a radicular nature. It is this characteristic that distinguishes cauda equina syndrome from other complications in which there is no acute pain.

Cauda equina syndrome is characterized by intense pain in the sacrum and lumbar region, which radiates to the buttocks, anogenital region and posterior surface of the thigh. In some cases, paresis, peripheral paralysis and sensory disturbances occur. Severe cases are characterized by paralysis of the buttocks and both legs. A feature of the complication can be considered the asymmetry of sensory and motor disorders.

Lumbar osteochondrosis can cause the development of myeloid "intermittent claudication" syndrome, in which there is weakness in the legs when walking, frequent urge to urinate, and numbness in the lower torso. The cause of this discomfort is insufficient blood supply to the lower parts of the spinal cord. After rest, these sensations disappear.

With ischemia of the roots of the cauda equina, caudogenic "intermittent claudication" occurs - goosebumps and tingling sensations when walking. Over time, this symptom can increase even more, affecting the perineum, genitals and groin. Leg weakness disappears after a short rest.

Compression of the Adamkiewicz artery can occur due to sudden unsuccessful movements, heavy lifting, or tremors. This complication of osteochondrosis of the lumbar spine manifests itself as disorders of the pelvic organs, loss of sensitivity, the appearance of bedsores and atrophy of the leg muscles.

Osteochondrosis of the lumbar spine is manifested by pain in the lower back. Due to prolonged stay in an uncomfortable position, pain may increase. After sleeping or resting in a supine position, the pain lessens or disappears completely.

The occurrence of stressful situations for the body can cause the development of an acute condition. Most often this happens during hypothermia, heavy loads and sudden movements. An exacerbation is characterized by severe pain, which can travel from the lower back to the legs. The body can try to independently reduce the load on the affected part of the spine through strong tension in the muscles of the lower back. A patient with osteochondrosis of the lumbar spine tries to find a comfortable position where the pain will subside.

Diagnosis of lumbar osteochondrosis

Diagnosis of osteochondrosis is carried out in several stages. The doctor needs to talk to the patient, ask about complaints, find out the nature of the pain, where it is located, at what moment the painful sensations are felt, their duration, intensity, etc. In addition, the doctor will know under what conditions the pain appears, when it intensifies or decreases.

After that, the vertebrologist examines the anamnesis, that is, the history of the disease. The doctor will definitely clarify how long the painful condition lasts, what was the cause of the pain and how you feel during the period when the discomfort disappears. An important point is preliminary treatment, as well as the effectiveness of certain treatment methods. A qualified doctor will certainly ask the patient about living and working conditions, range of motion, well-being under certain loads and previous illnesses. It is very important to know if the patient had spinal injuries, if they played sports and if any immediate relatives had spinal diseases.

The next step in diagnosis will be examination of the patient. The doctor will pay attention to the position of the head, legs and arms in relation to the body, gait, way of holding, symmetry of the body areas, condition of the skin in the injured area and the patient's movements. After this, the range of motion of the spine and the level of damage are established. To do this, the doctor will ask the patient to lean forward, sideways, backward, ask to move different parts of the back and tilt the head. A healthy person should not feel any crushing or joint pain during such a simple test.

If the patient does not suffer from osteochondrosis, he can reach his chest and shoulder with his chin. Head movements in each direction are about 60 degrees. A 45-degree angle is formed by bending sideways between the head and the upper part of the cervical spine. The distance from the sacrum to the spinous process of the seventh cervical vertebra increases by 5 to 7 centimeters when bending forward. This distance is reduced by 5-6 cm when folding back. An experienced vertebrologist will pay attention to how the knee and hip joints participate in flexion and how the configuration of the spine changes.

Treatment of osteochondrosis of the lumbar spine

Lumbar osteochondrosis requires complex, intensive and long-term treatment. This is especially true for chronic cases with multiple hernias and intervertebral protrusions.

Effectivetreatment of osteochondrosis of the lumbar spineit is achieved by reflex methods that do not cause side effects, but bring maximum benefit. Remember that recovery from such a serious illness cannot occur quickly. In each case of lumbar osteochondrosis, the doctor prescribes an individual treatment regimen.

It is worth noting that manual therapy can only be used in cases where the patient's spine is not damaged by protrusions and intervertebral hernias. The integrated use of these techniques allows you to restore normal blood microcirculation, eliminate congestion, vascular edema, relieve muscle spasms, restore the balance of metabolic processes in the tissues of the vertebrae and intervertebral discs, as well as improve the nutrition of the tissues of the lumbar region. As a result, the natural regeneration process is stimulated. It is worth noting that in the case of lumbar osteochondrosis, manual therapy should be aimed at improving the functions of the spine.

Treatment procedures for lumbar osteochondrosis are complemented by the use of herbal remedies that improve the body's innervation and also restore the balance of metabolic processes. The vertebrologist will recommend nutritional correction and a more active lifestyle to patients. It is important to adjust body weight, as excess weight puts additional pressure on the lower back and also aggravates the development of osteochondrosis of the lumbar spine.

An experienced specialist treating osteochondrosis allows the patient to achieve serious results, as well as avoid surgery, improve motor activity, eliminate lower back pain and comprehensively improve the body to avoid further exacerbations. Acute pain disappears after 1-3 sessions of manual therapy, and the positive effect of treatment is achieved on average after 10-15 sessions. Remember that the timely start of treatment is a guarantee of positive results.

During the period of exacerbation of low back pain, it is recommended that the patient remains in bed for 2 to 3 days. To quickly relieve pain, non-steroidal anti-inflammatory drugs, analgesics, venotonics, diuretics, nicotinic acid and B vitamins are prescribed. Walking with crutches, dry or underwater spinal traction can also be prescribed to unload the spine. If necessary, glucocorticoid blocks or paravertebral blocks with anesthetic are prescribed.

Physiotherapeutic treatment of osteochondrosis of the lumbar spine may also include electrophoresis, laser therapy and ultraviolet radiation. Physiotherapy is a mandatory component of a comprehensive treatment program. Some exercises can be used in the acute phase, but almost all exercises are recommended to be performed after pain has reduced. Thanks to regular physical exercise, tissue nutrition is restored, blood and lymph supply to intervertebral discs is improved, and the flexibility and elasticity of joints and cartilage are gradually restored. Thus, the patient's condition improves and the interval between periods of exacerbation increases.

Spa treatment also has a good effect on health. In climatic resorts, iodine-bromine, hydrogen sulfide and radon baths are prescribed.

Surgical treatment methods are used only if the patient's pain cannot be relieved by conservative methods for a long time, with paresis of the muscles of the lower extremities and disruption of the natural processes of urination and defecation. During the operation, the herniated disc is removed and the spinal segment is strengthened.

Prevention of lumbar osteochondrosis

Prevention of lumbar osteochondrosis consists in following simple rules recommended by a vertebrologist. Remember that the development of the disease can only be avoided by carefully following these rules, no matter what:

• Keep your lower back dry and warm, don't overcool your spine, and avoid drafts.
• Do not lift heavy objects or transport them over long distances.
• Try not to make sudden movements.
• Maintain correct posture when working and resting.
• Change positions whenever possible, trying not to stay in the same position for too long.
• Get physical therapy.
• Try not to bend over for too long.
• When cleaning, use long mops, a broom, and a vacuum cleaner with a long tube so you don't have to bend over.
• Lift weights correctly: bend over with your back straight, or bend your knees, pick up your bags with your back straight and stand up straight. Keep your hands with the load as close to your body as possible.
• If you need to bend down to pick something up off the floor, such as from under a table or bed, kneel down and keep your back straight.
• Distribute the weights equally between both hands.
• Strengthen your gluteal muscles, lengthen your spine, walk every day.
• Balance your diet, enrich your diet with dairy and plant products.
• Follow the drinking regime - 1. 5-2 liters of water and herbal teas per day.
• Get rid of bad habits - alcohol, smoking, drugs.