Pain in the back and lower back is one of the most common ailments in medicine.They are in second place in terms of the number of all requests, second only to respiratory diseases.A wide range of pathologies can cause pain in the lower back, but very often it is caused by osteochondrosis in the lower back.How to treat such a disease, what symptoms and signs it has, will be discussed below.
Not so long ago, medical science believed that osteochondrosis in the lumbosacral region occurs solely due to age-related changes that lead to wear of the vertebrae and intervertebral discs.But today the age symptom is not exclusive;osteochondrosis of the lumbar spine is diagnosed in patients of different age groups.Today, the cut-off age is considered to be more than 25 years.
Causes of lumbar osteochondrosis
It is impossible to name the exact reason;almost always it will be the complex effect of various destructive factors, among which the most important can be identified:
- Commitment to a passive lifestylefrom a motor point of view.Of their own volition, immobilized people, for example, who spend many hours at a computer, do not get enough useful load, which is why the "cross" muscles relax, and the load on the vertebrae increases.In addition, such a pastime is almost always associated with prolonged exposure to incorrect and unnatural positions.
- Problems with hormonal levels, which leads to metabolic disorders that affect the metabolism of spinal tissue in the lumbar region and contribute to destructive processes.This also includes diseases of an endocrine nature.
- Presence of congenital or acquired abnormalitieswhen the musculoskeletal system undergoes certain changes.This can be reflected in increased stress on the spine, for example in a patient with flat feet, curvature of the legs or spine.
- Chronically increased loadson the lower back.Here, risks include people with certain types of professional activities, usually associated with heavy lifting.This also includes professional athletes who constantly subject their bodies to peak loads.
- Disturbed food intake and daily routine.This also includes regular exposure to stress.These factors affect metabolic processes and affect the body's periodic recovery of its strength.
Degrees of osteochondrosis of the lumbar spine
The above pathological factors gradually lead to the manifestation of the disease.However, it can manifest itself in different ways, being practically asymptomatic in the beginning or causing barely tolerable pain during late development.Let's consider the main degrees of development of osteochondrosis:
- A situation where the nucleus pulposus moves within the intervertebral disc.It is characterized by pain caused by irritation of the nerve roots in the fibrous ring and longitudinal ligament.Discomfort is felt locally in the area where the defective disc is located.The pain can either be acute with shooting or constant dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the elements of the spine in this area increases, they become unstable relative to each other.To eliminate these pathological manifestations, it is necessary to constantly keep the muscles in this area tense, which ultimately leads to chronic fatigue in the lower back.
- Next, there is a breakthrough in the fibrous annulus, which causes the nucleus to escape beyond the disc border, forming an intervertebral hernia.Such a case will be accompanied by pinching of the nerve endings, which is called "radicular syndrome."
- The next degree of osteochondrosis of the lumbosacral region occurs with severe deformation of the spine in this part.Problems with mobility occur, but the pain syndrome strangely subsides at this stage.However, you should not rejoice;it does not mean that the disease is dying out.
- The last degree is characterized by pathological growth of bone tissue and a general deterioration of health.
Based on the degree of lumbar osteochondrosis, certain treatment methods are used.
Symptoms of osteochondrosis in the lower back
The main symptom is combat syndrome in the lumbar spine.At the same time, the sensations of pain, the area of their localization and the direction in which they spread can vary.This happens due to the fact that certain nerve receptors are irritated based on the degree of damage to the intervertebral disc and surrounding tissue.In addition, the presence of a protrusion or hernia itself, the direction of its protrusion and many other factors play a role.
The main symptoms of osteochondrosis of the lumbar spine include:
- The presence of aching pain in the lower back, which tends to intensify with sudden movements or, conversely, staying without changing position for a long time.The pain decreases if you take a horizontal position.
- In addition, weakness in the area of the body below the abdomen, including the lower extremities, is likely, as well as a blunted tendon reflex in the legs.
- There is a high probability of curvature in the lumbar spine.There is a classification of such curvatures, for example, when the weight is on the right or left side, they talk about scoliosis, lordosis is the situation of forward bending, and kyphosis is the case when the natural lumbar curve is leveled, so to speak.
- With a severe degree of development of the disease, it is possible to squeeze the spinal canals, which can cause its dysfunction and lead to uncontrolled urination and defecation.
Additional symptoms include:
- The presence of numbness and "coldness" of the skin on the lower back and buttocks.
- Flaky, dry and blue skin in the same places.
- Decreased urination.
- Erection problems.
The presence of these symptoms should alert a person;one should not give up on them, this will only lead to greater neglect.In this case, you should definitely consult a doctor for accurate diagnosis and treatment.The treatment can be either in hospital or at home, but more on that a little later.
Diagnosis of the disease
When making a diagnosis, it is important to understand the extent to which the disease has developed.The easiest way is to palpate the lower back to identify areas of pain.Typically, this method is not very informative, and in addition, studies are carried out that give a more detailed clinical picture:
- By radiography, a cheap and widespread method, it is possible to assess the condition of both the spine as a whole and individual vertebrae, for example the lumbar region in question.The technique is not very precise;it only allows us to indirectly understand how intact the intervertebral discs and spinal canals are.
- Computed tomographya more accurate method that allows you to assess the level of damage to the discs between the vertebrae, nerve roots and canals with the spinal cord.
- Magnetic resonance imagingthe most accurate method, provides a complete picture of the lesion in detail, but is quite expensive and unavailable.
It should be noted that the diagnostic process is very important, since all the details of the developed osteochondrosis are important for the doctor when he prescribes treatment tactics.
Complications of osteochondrosis
The main complications of the pathology are hernias and protrusions, which inevitably occur if treatment is neglected and the development of the disease is left to chance.Other complications may include:
- Inflammation of the sciatic nerve.
- Spondyloarthrosis.
- Schmorl's hernia.
- Spondylosis.
- Problems caused by pinched spinal canals.
- Functional disorders of the pelvis.
- Development of lameness.
Treatment of lumbar osteochondrosis
When diagnosed with osteochondrosis of the lumbar spine, a wide range of therapy is required, the main aspects of which will be:
- Application of moderate loads.
- Special medicines.
- Pull the spine.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massage.
The term "treatment" for osteochondrosis implies:
- Suppression of inflammation.
- Relieving pain syndrome.
- Complex for strengthening the lower back and adjacent muscle groups.
- Relief of chronic muscle tension.
- Increasing the functionality of organs in the pelvis.
- Normalization of blood circulation and metabolism in the pathological area.
Treatment with medication
A similar approach to the treatment of lumbar osteochondrosis includes taking medications, injections of special drugs, and the use of ointments and gels for external use.The main task of such drugs is to neutralize pain and inflammation.
Based on the degree of osteochondrosis of the spine in the lumbar region, the doctor may prescribe the following drugs:
- Analgesics that have a pain-relieving effect.
- Drugs against inflammation of non-steroid origin.
- For muscle spasms, antispasmodics.
- Medicines for the restoration of cartilage tissue, called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in traditional medicine.
- For severe pathologies, when the above means do not help, resort to corticosteroids.
- Vitamin complexes.
In addition to these medications, medications are prescribed in tablets whose purpose is to calm the nervous system and combat stress and depression.
Physiotherapy treatment of lumbar osteochondrosis
The treatment process is rarely limited to just taking pills.The pathology in question cannot be cured without stimulating the restoration processes in the spine.For these purposes, a wide range of physiotherapeutic procedures are used, the most popular of which are:
- Phonophoresis.
- Therapy with diadynamic currents.
- Laser therapy.
In addition, useful loads must be applied to the spine while at the same time being stretched.Various forms of therapeutic massage are ideal for this.It should be remembered that massage is only used when the pain is relieved.As a rule, it is carried out as a restorative measure when the process of remission of the disease has begun, or in chronic osteochondrosis.After a massage, muscles overworked by illness are well relaxed;its effect will be greatly improved when heated at the same time, for example in a bathhouse or sauna.In the latter case, we will achieve maximum effect due to additional stimulation of blood circulation in the pathology zone and adjacent areas.
Another method of physical therapy is manual therapy.Its benefits are generally the same as those of massage, but in addition, with the help of such techniques, a specialist is able to return displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercises are also used as a restorative and preventive measure during the period when pain and inflammation have already been relieved.The key to the high effectiveness of therapeutic exercises is the regularity of the exercises;in this case, the damaged area will constantly receive the necessary physical activity for self-generation of new tissue and recovery.
Surgical operations for lumbar osteochondrosis
Surgery is a last resort, which is prescribed for severe complications.The most common of these is intervertebral hernia, when a so-called "discectomy" or removal of the affected intervertebral disc is performed.The operation is very effective, but as it is a last resort, it is prescribed only if other treatment methods have failed for more than 6 months.Modern medicine also offers less traumatic methods of performing such an operation, for example, microsurgical or endoscopic methods.