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What is lumbar osteochondrosis

pain with lumbar osteochondrosis

Osteochondrosis of the lumbar region occurs due to deformation and destruction of the cartilage tissue of the intervertebral discs.Without cartilage, the vertebrae lose their flexibility and become dislocated, causing pain.According to the WHO, the disease primarily affects people over 30 years of age.Women get sick three times more often, which is also related to age-related changes and a decrease in the body's calcium level.

Osteochondrosis of the lower back

Among all diseases of the peripheral nervous system, osteochondrosis of the spinal column accounts for 80%, 60-80% of which affect the lumbar region consisting of 5 vertebrae.In 40% of people, the first signs of the disease appear at the age of 30-35.In old age, osteochondrosis of the spine is diagnosed in 90% of people.Painful sensations are experienced by 7 out of 10 people, the exacerbation can last 6-16 months.

Stages of development

  • 1. – the development of degenerative disorders that affect the nerve endings and disrupt the blood supply.The inflammatory process causes pain that radiates into the legs.The patient sometimes experiences tingling in the back and buttocks.Appears after heavy physical exertion.
  • 2. – the outer shell of the intervertebral disc (fibrous ring) is destroyed.The distance between the vertebrae decreases, the nerve endings are compressed, which causes severe, acute pain.The symptoms appear especially when walking.
  • 3. – due to excessive mobility of the vertebrae, muscle fibers and nerve endings are compressed.Spasms, numbness, burning pain, hernia appear - displacement of the intervertebral disc into the spinal cord.
  • 4. – growth of pathological exostosis on the bone structure.The spine literally “turns to stone”.Progressive arthrosis and lack of treatment immobilize the patient.

Reasons for development

The disease develops slowly, under the confluence of many circumstances, that is, the development of the disease does not depend on the influence of one but several factors:

  • Sedentary lifestyle (physical inactivity), sedentary work, low level of physical activity.At first glance, they are not dangerous.However, with long-term exposure, the muscle tone, the so-called "muscle stringer", weakens.It supports the spine and internal organs.In this way, physical inactivity causes a disturbance in the functioning of many systems - blood circulation, breathing, digestion.
  • Overweight.With a BMI (Quetelet body mass index) above 25 kg/m2, being overweight means an additional burden on the body: it puts pressure on the spine, overloads the joints, and impairs the blood supply.
  • Endocrine pathological processes.Hormonal imbalance, disorders of the adrenal glands and thyroid gland "slow down" the body's metabolism.Frequent hormonal changes "wash" calcium out of bone tissue, making it weak and brittle.
  • An unbalanced diet.Popular and affordable fast food fully satisfies the body's energy needs, while it is completely useless in terms of saturating the body with necessary vitamins and microelements.
  • Pathologies and genetic predisposition to diseases of the locomotor system.
  • Age-related degenerative changes.As a result of time, the support system naturally wears and wears out.

Lumbar osteochondrosis occurs many times more often in men whose profession involves significant physical activity.

Symptoms of lumbar osteochondrosis

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

Spinal nerves run from the trunk of the spine to various parts of the body.Each nerve is responsible for a certain area.This is called "segmental innervation".This is the reason why the affected nerve "reacts" in a specific area: this is how the "radicular syndrome" manifests itself.

The spinal nerve map allows pain to be identified with a specific area of the spine: C1-C8 - 8 cervical, T1-T12 - 12 thoracic, L1-L5 - 5 lumbar, S1-S5 - 5 sacral, C0 - 2 coccyx.Signs of osteochondrosis depending on segmental innervation:

  • L3-L4 – weak knee reflex, partial numbness, episodic loss of feeling is observed on the front surface of the thigh;
  • L4-L5 – muscle weakness, the patient cannot fix his body while standing on a corner, the pain and sensitivity disorder extends from the lower back to the buttocks, as well as the entire lateral surface of the thigh (from top to bottom).
  • L5–S1 – trembling in the calf muscle, inability to stand on toes, pain in the back of the thigh.

In rare cases, the radicular arteries are also involved in the destructive process, provoking a spinal cord stroke - a dangerous pathology in which the patient experiences paresis and paralysis, as well as dysfunction of the pelvic organs.

Pain reflex symptoms

  • Lumbago or lumbago (not sciatica in this case!) – acute pain.Any awkward movement, even sneezing and coughing, triggers spasms.The patient spontaneously changes his body position, moving to the side.Attempting to assume a vertical position causes a new lumbago.
  • Lumbodynia is a dull and aching pain that occurs on one side.Periods of remission are followed by exacerbations, which gradually turn into severe pain.
  • Lumboischialgia - painful sensations appear in the legs.

The side symptoms of the disease are not so typical and can easily be confused with the symptoms of another problem: sweating (hypohidrosis), paleness of the skin of the affected area due to poor blood circulation, severe dryness and peeling.

Diagnostics

In the initial stage, the patient's complete medical history is collected.The overall picture must be completed with the opinion of a surgeon, orthopedist, neurologist, rheumatologist.Specialists perform a visual examination of the patient to assess changes in posture, muscle tone and skin sensitivity.

An X-ray examination is performed for the primary diagnosis of grade 1 lumbar osteochondrosis;it is used to examine the condition of the intervertebral discs, pathologies of the spinal cord, and to assess the general condition of the spine.However, this type of diagnosis does not provide complete information about the affected tissues.

Computed tomography (CT) is an extremely sensitive examination using ionizing rays.The CT scan records layer by layer the degree of disc deformation, inflammatory processes of the spinal cord membrane and nerve endings.

Magnetic resonance imaging (MRI) shows the general condition of muscle mass, blood vessels and ligaments in an informative way.Detects tumors and inflammatory processes.

Myelography is one of the methods for visual assessment of the condition of the spinal cord and nerve roots, by injecting a contrast material with the help of a needle into the cavity filled with cerebrospinal fluid between the pia mater and the arachnoid of the spinal cord.Like CT, MTP and X-ray, the procedure is done in real time.

Neurological examination of the sensitivity and reflexes of pathologies is a complex of tests that includes a screening method for studying the symmetry of the limbs, testing vibration sensitivity, and evaluating the Babinsky, Chaddock, and Oppenheimer reflexes.

Treatment of lumbar osteochondrosis

The effectiveness of conservative treatment is achieved by a combination of drugs from different groups, massage and manual therapy.However, in stage 3, lumbar osteochondrosis can no longer be cured by conservative methods;surgical intervention is required.One of the surgical methods for osteochondrosis is microdiscectomy.This is a neurosurgical operation to remove the hernia without damaging the nerve structures.It is performed under general anesthesia.The patient can walk on the 3rd day.

Drug therapy (stages 1-2)

  • Pain relievers: local (ointments, gels), oral (tablets, suspensions), intramuscular (injection solutions).
  • Non-steroidal anti-inflammatory drugs to prevent the development of the inflammatory process.Reduces temperature, removes swelling.Gels and tablets are most often used, in more severe cases (inflammation of the sciatic nerve) - injections.Prima course - 7-14 days.
  • Muscle relaxants.In the acute period of muscle spasms, as well as in the period of remission, in order to consolidate the effect.
  • Chondroprotectors.Blocks destructive processes in intervertebral discs, promotes regeneration, improves metabolism in cartilage tissues.
  • Vascular drugs.It helps to normalize the blood supply of the musculoskeletal system.
  • B group vitamin complexes.They improve nerve conduction.
  • Diuretics.Reduces swelling.

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

Twice a year, a manual therapy course that relieves muscle tension and spasms, restores blood circulation, improves lymph circulation, and increases locomotor mobility is also recommended.

Prevention

  • Active lifestyle combined with moderate physical activity;
  • Choosing comfortable or, where applicable, orthopedic shoes;
  • Good nutrition;
  • Body weight control;
  • Sleep only on an orthopedic mattress and pillow;
  • Office furniture with a flat back only;
  • Avoiding heavy loads on the back and spine.When carrying heavy objects, the load must be evenly distributed in both hands.