Osteochondrosis of the lumbar spine

One of the most common diseases today isosteochondrosis of the lumbar spine. Both men and women often turn to doctors with this disease.

At least once in our life, each of us has experienced pain in the lower back, sacrum or lower extremities. We often unconsciously call this type of pain "pressed 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 upright posture. However, not all people suffer from osteochondrosis. Provocative factors that accelerate the development of the disease are: metabolic disorders, physical inactivity, injuries, excess weight, improper weight lifting.

The source of pain in osteochondrosis is pinched nerve roots, which occur after the elongation of the intervertebral disc and the narrowing of the intervertebral gap. This deviation is formed when nutrition deteriorates, the natural processes of oxygen and lymphatic exchange in the tissues of the intervertebral discs are interrupted. As a result, the shock-absorbing ability of the intervertebral discs decreases, and the nucleus pulposus of the disc gradually shrinks and dries up.

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

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

The pain syndrome is formed due to compression of the spinal nerve in lumbar osteochondrosis and is called lumboischialgia. This symptom is accompanied by numbness of the lower extremities. Depending on the nature and location of the pain, the disease can be divided into sciatica and lumbago. Inflammation of a nerve due to compression is called radiculitis. The methods of treating radiculitis with painkillers, in fact, are only the elimination of symptoms and are ineffective, because such treatment does not affect the real cause of the disease, namely the degenerative processes in the intervertebral discs. To eliminate pain and take preventive measures to prevent complications, you need to undergo a comprehensive treatment course to activate the restoration processes in the disc tissues, to normalize the height and physiological parameters of the intervertebral discs.

Symptoms of osteochondrosis of the lumbar spine

One of the signs of osteochondrosis is the compression of the nerve roots of the spine 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 corresponding to a compressed root:

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

Osteochondrosis of the lumbar spine can cause protrusion and herniation 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 at the right time. Do not delay your visit to a vertebrologist, do 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 as a complication of lumbar osteochondrosis. This pathology develops due to damage to the blood supply of 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, weakened ligaments, the formation of osteophytes and neoathrosis. 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 stuck opening of the canal may develop. This effect is called "narrow bed".

Vertebrologists identify another serious complication of osteochondrosis of the lumbar spine. Compressive myelopathy is a disorder of the spinal cord 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 TXII-L1 disc herniation, which exerts pressure and provokes damage to the S1-S2, L2-L-4 segments of the spinal cord. A patient with this complication feels pain in the lower back, the lower leg, the back of the thigh, as well as weakness in the leg. The gluteal and calf muscles gradually become hypotonic and hypotrophic, the Achilles and plantar reflexes decline and leg paresis is formed. The back and outer surfaces of the foot and lower leg are characterized by reduced sensitivity or its complete absence.

If a LI-II disc herniation develops, in which excessive pressure increases in the coccygeal segment S3, osteochondrosis of the lumbar spine has the following symptoms: disruption of the pelvic organs, fecal and urinary incontinence, constipation, loss or decreased sensitivityanogenital area, development of bed sores, anal prolapse reflex.

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

Cauda equina syndrome is characterized by severe pain in the sacrum and lower back, which radiates to the buttocks, anogenital region and the 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 characteristic feature of the complication can be considered the asymmetry of sensory and motor disorders.

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

With ischemia of the roots of the cauda caudate, caudogenic "intermittent claudication" occurs - lumps and tingling sensations when walking. Over time, this symptom can grow higher, reaching the perineum, genitals and groin. Weakness in the legs goes away after a short rest.

Compression of the Adamkiewicz artery can occur due to sudden unsuccessful movement, heavy lifting or shaking. This complication of osteochondrosis of the lumbar spine is manifested as disorders of the pelvic organs, loss of sensitivity, appearance of bed sores and leg muscle atrophy.

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

The appearance 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 aggravation is characterized by severe pain, which from the lumbar region can go down to the legs. The body can independently try to reduce the load on the affected part of the spine with strong tension in the muscles of the lower back. A patient with osteochondrosis of the lumbar spine tries to find a comfortable position in which the pain decreases.

Diagnosis of lumbar osteochondrosis

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

After that, the vertebrologist examines the history, d. m. th. 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 definitely ask the patient about living and working conditions, range of motion, well-being under certain loads and past illnesses. It is very important to find out if the patient had spinal injuries, if he was involved in sports and if any close relatives had spinal diseases.

The next step in the diagnosis will be the examination of the patient. The doctor will pay attention to the position of the head, legs and arms in relation to the body, gait, posture, symmetry of the body areas, the condition of the skin in the damaged area and the patient's movements. After that, the range of motion of the spine and the level of damage are determined. To do this, the doctor will ask the patient to bend forward, sideways, backward, ask him to move different parts of the back and tilt his head. A healthy person should not experience any tingling or pain in their joints during such a simple test.

If the patient does not suffer from osteochondrosis, then he can reach his chest and shoulder with a beard. Head movements in each direction are about 60 degrees. An angle of 45 degrees is formed by bending laterally between the head and the upper cervical spine. The distance from the sacrum to the spinous process of the seventh cervical vertebra increases by 5-7 centimeters when bending forward. This distance decreases by 5-6 cm when you lean back. An experienced vertebrologist will pay attention to how the knee and hip joints participate in bending 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 intervertebral hernias and protrusions.

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

It is worth noting that manual therapy can be used only 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 tissue nutrition inthe middle region. As a result, the natural regeneration process is stimulated. It is worth noting that in 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 medicines that improve innervation in the body and also restore the balance of metabolic processes. The vertebrologist will recommend to patients the correction of nutrition and a more active lifestyle. It is important to regulate body weight, because excess weight puts additional pressure on the lower back and also aggravates the development of osteochondrosis of the lumbar spine.

An experienced specialist who treats osteochondrosis allows the patient to achieve serious results, as well as avoid surgery, improve motor activity, eliminate back pain and completely improve the body to prevent further deterioration. Acute pain goes away after 1-3 sessions of manual therapy and the positive effect of the treatment is achieved on average after 10-15 sessions. Remember that starting the treatment on time is a guarantee of achieving positive results.

During the period of worsening pain in the lower back, the patient is recommended to stay in bed for 2-3 days. To quickly relieve pain, non-steroidal anti-inflammatory drugs, pain relievers, venotonics, diuretics, nicotinic acid and B vitamins are prescribed. Walking with crutches, dry or underwater traction of the spine may also be prescribed to unload the spine. If necessary, blockades with glucocorticoids or paravertebral blockades with anesthesia are prescribed.

Physiotherapy treatment of osteochondrosis of the lumbar spine may also include electrophoresis, laser therapy and ultraviolet radiation. Physical therapy 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 the pain has subsided. Thanks to regular physical exercises, tissue nutrition is restored, blood and lymph supply to the intervertebral discs is improved, and the flexibility and elasticity of the joints and cartilage are gradually restored. Thus, the patient's condition improves, and the interval between periods of deterioration is extended.

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 processes of urination and natural defecation. During the operation, the disc herniation is removed and the spinal segment is strengthened.

Prevention of lumbar osteochondrosis

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

• Keep the lower back dry and warm, do not chill the spine and avoid drafts.
• Do not lift heavy objects or carry them for long distances.
• Try not to make sudden movements.
• Maintain proper posture when working and resting.
• Change your position as often as possible, trying not to stay in one position for a long time.
• Get physical therapy.
• Try not to stay in a bent position for a long time.
• When cleaning, use a long mop, a broom and a vacuum cleaner with a long hose so you don't have to bend over.
• Lift weights correctly: bend with a straight back or bend the knees, pick up the bags with a straight back and stand up straight. Keep your hands with the load as close to your body as possible.
• If you have to bend over to lift something off the floor, such as under a table or bed, get down on one knee and keep your back straight.
• Distribute the weight evenly between the two hands.
• Strengthen the gluteal muscles, stretch the spine, take a walk every day.
• Balance your diet, enrich your diet with dairy and plant products.
• Adhere to the drinking regimen - 1. 5-2 liters of water and herbal teas per day.
• Give up bad habits - alcohol, smoking, drugs.