Spinal osteochondrosis is a chronic degenerative disease that affects the vertebrae, intervertebral discs, vertebral joints, ligaments and other tissues of the musculoskeletal system. Many people believe that only adults and the elderly are susceptible to the disease. However, in recent years this diagnosis has increasingly been made among young people and even children. If osteochondrosis is not treated, serious complications can occur.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used to relieve pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral and in several places at once. However, the lumbosacral region is most commonly affected. This is because the lower back bears the greatest load even during simple everyday activities: lifting heavy objects, walking, running, sitting. The lumbar vertebrae are the largest, so the discs that separate them are also the largest. Next to the cervical spine, the lumbar spine is the most mobile part of the spine. This fact, together with the highest load, makes it a popular "target" of osteochondrosis.
The pathology initially affects the intervertebral discs, which lose their elasticity, become "dry" and lose height. Their shock-absorbing function is disrupted, as a result of which the vertebrae move closer together. The inner part of the intervertebral disc, called the nucleus pulposus due to its softness, begins to bulgeand pushes the surrounding fibrous ring to the side. This creates protrusions and hernias. They can compress the longitudinal ligaments of the spine and the spinal nerve roots and thus cause pain.
causes
The exact cause of osteochondrosis is unknown. However, the fact that the disease is often diagnosed in representatives of certain groups suggests that lifestyle has a major influence on the development of the disease. People with a lack of physical activity and sedentary work are particularly affected. A passive lifestyle weakens the muscular corset and reduces the mobility of the spine. As a result, the muscles lose the ability to hold the spine in the correct physiological position, which leads to rapid wear and tear on the spine.
The main risk factors for the development of osteochondrosis include:
- frequent lifting of heavy objects;
- overweight, obesity;
- endocrine diseases, hormonal imbalance;
- poor nutrition, insufficient intake of vitamins, proteins and minerals;
- burdened heredity;
- excessive physical activity;
- back injuries;
- posture disorders;
- inflammatory diseases of the joints: arthritis, arthrosis;
- congenital anomalies of the spine;
- Flat feet;
- Pregnancy, especially multiple pregnancy.
Symptoms
The insidious thing about osteochondrosis is that it can be asymptomatic for many years. At first there is slight pain and discomfort in the lower back area, which disappears on its own after a short rest. Typically, patients do not pay attention to these signs and do not consult a doctor. But gradually the intensity of the unpleasant sensations increases and to relieve them, more rest or taking a painkiller is required.
Pain in the lower back with osteochondrosis is the main symptom of the pathology. The type, severity and location can vary greatly - it depends on what exactly is causing the pain. Most often, patients complain of aching pain, which increases with physical activity, prolonged standing while stationary, sneezing and coughing. Sometimes the pain spreads to the leg, sacrum and buttocks. Unpleasant sensations disappear when lying on your back. Acute and stabbing pain is often described by patients as a "shot in the back".
Other common complaints:
- Stiffness and tension in the back muscles;
- Sensitivity disorders in the lower extremities of varying severity, tingling "goosebumps" on the legs;
- limited mobility of the spine;
- Change in gait, limping due to severe back or leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- Crunching in the back when bending or turning;
- Urinary and fecal incontinence or, conversely, constipation and urinary retention.
Symptoms of lumbar osteochondrosis can be supplemented by some gynecological diseases and infertility in women, and infertility and erectile dysfunction in men.
diagnosis
Diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. In addition, laboratory and instrumental examination methods are carried out to assess the condition of the spine and the body as a whole.
At the initial consultation, the doctor will carry out the following:
- Opinion poll.The specialist clarifies the complaints, the time of their occurrence and the presence of a connection with provoking factors: physical activity, prolonged static posture, sudden movement, hypothermia. He also studies medical documentation - doctor's reports and the results of previous examinations.
- inspection. The doctor examines the skin and spine for visible injuries, damage and deformities. He assesses the gait and symmetry of the limbs.
- Palpation. When palpating the spine, pain, the presence of compactions or deformities are noted.
- Neurological examination. A consultation with a neurologist necessarily includes an assessment of the muscle strength of the limbs, their sensitivity, as well as the symmetry of tendon reflexes.
The patient is then referred for a more detailed diagnostic examination. To assess the condition of the body, laboratory tests are prescribed:
- general and biochemical blood test, including assessment of inflammatory indicators – ESR and C-reactive protein;
- general urinalysis.
Intervertebral osteochondrosis of the lumbar spine is confirmed by instrumental diagnostic methods:
- X-ray in two projections. An x-ray helps to assess the condition of the bones, detect anomalies in the development of the spine, detect formed osteophytes and pathological changes in the joints.
- CT. A slice-by-slice CT image allows for a more detailed examination of the spine. It visualizes vertebrae, bone growths and other important defects. A CT scan with intravenous contrast shows the condition of the blood vessels and blood circulation in the tissue.
- MRI. The preferred diagnostic method because it allows you to obtain a large amount of accurate information quickly and without radiation. An MRI image visualizes the condition of cartilage, ligaments, intervertebral discs, spinal nerve roots, spinal cord and other soft tissues.
Which doctor should I contact?
Diagnosis and treatment of osteochondrosis is carried out by doctors of various specialties: neurologists, vertebral doctors, orthopedic traumatologists. A physiotherapist, a masseur, an acupuncturist and a physiotherapist are called in for therapeutic interventions. Doctors from all of these specialties work in clinics. Qualified specialists conduct a comprehensive examination and prescribe effective treatment individually for each patient.
It is important not to self-medicate but to seek professional help immediately. Many people do not know why lumbar osteochondrosis is dangerous and how it can affect everyday life. If this disease is ignored, it can lead to serious and often irreversible health consequences. Therefore, do not delay your visit to the doctor and register for a consultation at the clinic at the first signs of the disease.
Treatment
What to do with lumbar osteochondrosis in men and women can only be told by a qualified doctor. Self-medication is strictly contraindicated - it can worsen the course of the disease. The doctor selects treatment tactics strictly individually, taking into account the peculiarities of each patient:
- Age,
- stage of osteochondrosis,
- current health status,
- the presence of concomitant diseases,
- Pregnancy and breast feeding period.
Treatment methods for osteochondrosis of the lumbar spine:
- Drug therapy.
The type of drug, its dosage, frequency and duration of administration are selected by the doctor. Depending on the clinical case, the following is prescribed:
- Non-steroidal anti-inflammatory drugs.They have an anti-inflammatory and pain-relieving effect. They are prescribed taking into account the severity of pain and concomitant diseases, especially of the gastrointestinal tract and cardiovascular system.
- Muscle relaxants.Eliminate strain on back muscles and reduce pain.
- Glucocorticosteroids.Sometimes used for severe pain and inflammation.
If the pain is severe, it is possible to prescribe medicinal blockades. During the procedure, painkillers and anti-inflammatory medications are injected directly into the source of the pain - at a site next to the pinched nerve. This allows you to quickly relieve pain, improve mobility of the spinal joints and improve the patient's general well-being.
- Physical therapy.
Physiotherapeutic procedures improve well-being, enhance the effects of prescribed medications and accelerate tissue regeneration. For osteochondrosis, the following is recommended:
- shock wave therapy,
- magnetic field therapy,
- Laser therapy.
To achieve maximum therapeutic results, physiotherapy treatment is required, which consists of several procedures. The doctor determines the duration and frequency of physiotherapy individually.
- Massotherapy.
Massage is indicated outside the exacerbation phase. It is carried out by a qualified massage therapist who, taking into account the medical history, selects tactics for influencing the body. You may feel better after the first session, but multiple procedures are required for lasting results. One of the main advantages of therapeutic massage is its additional effect on the psycho-emotional state. During a massage, endorphins are released – hormones of desire and joy.
- Acupuncture.
The essence of acupuncture is that the doctor inserts special sterile needles into specific points on the body. They act on active points in the projection of nerve endings that lead to the source of inflammation and pain. The method helps to relieve pain, relax muscles and improve mobility of the spine.
- Therapeutic physical education (physiotherapy).
Exercise therapy is indicated in the remission phase, i. e. when there is no acute pain. The aim of the exercises is to stretch and relax the muscles of the spine, strengthen them and increase the mobility of the spinal joints. Remedial gymnastics increases blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and correct physiotherapy, including at home, prevents the disease from worsening and the occurrence of an attack of pain. And even with acute pain, bed rest is contraindicated; exercise is necessary.
Follow
The most common consequences of lumbar osteochondrosis are caused by a formed hernia that compresses the roots of the spinal nerve. As a result, the following neurological symptoms occur:
- Paresis or paralysis of the lower extremities, most commonly the feet;
- Numbness, crawling sensation in the lower extremities;
- Disorder of the urogenital system and intestines.
A large hernia can compress the spinal cord, which is called discogenic myelopathy. In this case, persistent neurological symptoms develop, sometimes leading to disability. Among the complications of osteochondrosis, spondylosis should also be highlighted - this is stiffness of the joints between the vertebral arches. The disease leads to a severe restriction of movement in the spine.
Another unpleasant complication is chronic pain syndrome, which lasts over 12 weeks and disrupts the patient's psycho-emotional state.
prevention
The following will help prevent the development and progression of lumbar osteochondrosis:
- regular physical activity, gymnastics;
- control of body weight;
- Hourly warm-up for sedentary work and prolonged stay in a stationary position;
- right nutrition;
- visiting the swimming pool;
- yoga and pilates classes;
- stop smoking and alcohol abuse;
- avoiding heavy physical activity, especially heavy lifting;
- Minimize stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. Prescribing therapy at the initial stage of the disease has a favorable prognosis for recovery. Early treatment stops degenerative processes and makes the patient's life painless and comfortable.