Osteochondrosis of the spine is a chronic degenerative disease that affects the vertebrae, intervertebral discs, facet joints, ligaments and other tissues that make up the musculoskeletal system. Many people believe that only adults and elderly people are susceptible to the disease. But in recent years, this diagnosis is more often given to young people and even children. If osteochondrosis is not treated, serious complications can develop.
Lumbar-sacral spine osteochondrosis is treated in clinics where conservative methods are used to relieve pain and stop the progression of the disease without surgical intervention.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral and several at the same time. But it mostly affects the lumbosacral region. This is because the lower back carries the heaviest load when performing even simple daily tasks: lifting heavy objects, walking, running, sitting. Lumbar vertebrae are the largest, so the intervertebral discs that separate them are also the largest. The lumbar region, along with the cervical region, is the most mobile part of the spine. This fact, together with the heaviest load, becomes a favorite "target" of osteochondrosis.
Initially, the pathology refers to intervertebral discs that lose their elasticity, become "dry" and decrease in height. Their shock absorption function is impaired, which causes the vertebrae to move closer together. Due to its softness, the inner part of the intervertebral disc called nucleus pulposus begins to bulge, pushing aside the fibrous ring located around it. This is how protrusions and tears are formed. They can compress the longitudinal ligaments of the spine and spinal nerve roots, causing pain.
Reasons
The exact cause of osteochondrosis is unknown. However, the fact that the disease is often diagnosed in representatives of certain groups shows that lifestyle has a great impact on the development of the disease. This primarily affects people who are not physically active and have a sedentary job. A passive lifestyle weakens the muscle corset and reduces the mobility of the spine. Because of this, the muscles lose their ability to hold the spine in the correct physiological position, which causes its rapid wear.
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 in the joints: arthritis, arthrosis;
- congenital anomalies of the spine;
- straight legs;
- pregnancy, especially multiple pregnancies.
Symptoms
The insidiousness of osteochondrosis is that it can be asymptomatic for many years. At first, it is a small pain and discomfort in the lower back, which passes by itself after a short rest. Typically, patients do not pay attention to these symptoms and do not consult a doctor. But gradually the intensity of unpleasant sensations increases, and to eliminate them, it is necessary to take more rest or painkillers.
Lower back pain with osteochondrosis is the main symptom of the pathology. Its nature, severity and location can be very different - it depends on what exactly caused the pain. Often, patients complain of painful pains that intensify during physical activity, standing for a long time in a stationary position, sneezing and coughing. Sometimes the pain spreads to the legs, sacrum and hips. Unpleasant feelings disappear while lying down. Often sharp and sharp pain is described by patients as a "kick in the back".
Other common complaints:
- stiffness and tension in the back muscles;
- sensitivity disturbance in the lower extremities of varying severity, creeping "goose bumps" feeling in the legs;
- limited mobility of the spine;
- a change in gait, a limp due to severe back pain or leg pain;
- muscle weakness in the legs;
- rachiocampis;
- creaking in the back when bending or turning;
- urinary and faecal incontinence or, conversely, constipation and urinary retention.
In women, the symptoms of lumbar osteochondrosis can be complemented by some gynecological diseases and infertility, and in men, infertility and erectile dysfunction.
Diagnostics
Diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. In addition, laboratory and instrumental examination methods are performed to assess the condition of the spine and the body as a whole.
In the initial consultation, the doctor conducts the following:
- Inquiry.The specialist clarifies complaints, the time of their occurrence and the existence of a connection with provoking factors: physical activity, long static posture, sudden movement, hypothermia. He also studies medical records - doctor's opinions and the results of previous examinations.
- Examination. The doctor examines the skin and spine for visible injuries, damage, and deformities. It evaluates gait and symmetry of limbs.
- Palpation. During palpation of the spine, pain, compression or deformations are revealed.
- Neurological examination. 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.
After that, the patient is sent for a more detailed diagnostic examination. Laboratory tests are prescribed to assess the condition of the body:
- general and biochemical blood test, including assessment of inflammatory indicators - ESR and C-reactive protein;
- general urinalysis.
Intervertebral osteochondrosis of the lumbar region is confirmed by instrumental diagnostic methods:
- X-ray in two projections. X-ray imaging helps to evaluate the condition of bones, to identify abnormalities in the development of the spine, to detect formed osteophytes and pathological changes in the joints.
- CT. Layer-by-layer CT imaging allows for a more detailed study of the spine. It visualizes vertebrae, bony growths and other important defects. Intravenous contrast-enhanced CT scan shows the condition of blood vessels and blood circulation in tissues.
- MRI. It is the preferred diagnostic method because it allows obtaining a large amount of accurate information quickly and without radiation. An MRI image visually shows the condition of cartilage, ligaments, intervertebral discs, spinal nerve roots, spinal cord and other soft tissues.
Which doctor should I see?
Diagnosis and treatment of osteochondrosis is carried out by doctors of several specialties: neurologist, vertebrologist, orthopedic traumatologist. A physiotherapist, massage therapist, acupuncturist and physical therapy specialist are involved for therapeutic procedures. Doctors of all these specialties work in the clinics. Qualified specialists conduct a comprehensive examination and prescribe an effective treatment for each patient individually.
It is important not to self-medicate, but to immediately seek help from specialists. Many people do not know why lumbar osteochondrosis is dangerous and how it can affect daily life. If this disease is ignored, it can have serious and often irreversible health consequences. Therefore, do not delay your visit to the doctor and sign up for a consultation at the clinic at the first signs of the disease.
Treatment
Only a qualified doctor can tell what to do with lumbar osteochondrosis in men and women. Self-medication is strictly contraindicated - it can aggravate the course of the disease. The doctor chooses the treatment tactics strictly individually, taking into account the characteristics of each patient:
- age,
- stage of osteochondrosis,
- current health,
- the presence of concomitant diseases,
- pregnancy and lactation period.
Methods of treatment of lumbar osteochondrosis:
- Drug therapy.
The type, dosage, frequency and duration of the drug are selected by the doctor. Depending on the clinical situation, the following are prescribed:
Non-steroidal anti-inflammatory drugs. They have anti-inflammatory and analgesic effect. They are prescribed taking into account the severity of pain and accompanying pathologies, especially from the gastrointestinal tract and cardiovascular system.Muscle relaxants. Relieve back muscle tension and reduce pain.Glucocorticosteroids. It is sometimes used for severe pain and inflammation.
In cases of severe pain, it is possible to prescribe drug blockades. The procedure involves injecting pain relievers and anti-inflammatory drugs directly into the source of pain - a point near the pinched nerve. This allows you to quickly relieve pain, improve the mobility of the spinal joints and the general well-being of the patient.
- Physiotherapy.
Physiotherapy procedures improve well-being, increase the effect of prescribed drugs and accelerate tissue recovery. The following is recommended for osteochondrosis:
- shock wave therapy,
- magnetic therapy,
- laser therapy.
To achieve maximum therapeutic results, it is necessary to undergo a course of physiotherapeutic treatment consisting of several procedures. The doctor determines the duration and frequency of physical therapy individually.
- Massage therapy.
Massage is indicated outside the period of exacerbation. It is performed by a qualified masseur who chooses the tactics of influencing the body, taking into account the history of the disease. You may feel better after the first session, but several procedures are needed for permanent results. One of the main advantages of therapeutic massage is its additional effect on the psycho-emotional state. Endorphins - hormones of pleasure and joy - are released during massage.
- Acupuncture.
The essence of acupuncture is that the doctor places special sterile needles in certain points of the body. They act on active points in the projection of nerve endings leading to the source of inflammation and pain. The method helps to relieve pain, relax muscles and improve spinal mobility.
- Therapeutic physical education (physical therapy).
Exercise therapy is indicated during the period of remission, that is, when there is no acute pain. Exercises are aimed at stretching and relaxing the muscles of the spine, strengthening them and increasing the mobility of the spinal joints. Therapeutic gymnastics increases blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and proper physical therapy, even at home, prevents the aggravation of the disease and the onset of pain attacks. And even during periods of acute pain, bed rest is contraindicated, it is necessary to move.
Results
The most common consequences of lumbar osteochondrosis are caused by a formed tear that compresses the roots of the spinal nerve. As a result, the following neurological symptoms occur:
- paresis or paralysis of the lower extremities, mostly the legs;
- numbness, crawling sensation in the lower extremities;
- disorders of the genitourinary system and intestines.
A large hernia can compress the spinal cord, which is called discogenic myelopathy. In this case, persistent neurological symptoms develop, which sometimes lead to disability. It is also worth highlighting spondylosis among the complications of osteochondrosis - this is the stiffness of the joints between the vertebral arches. The disease leads to a sharp limitation of movements in the spine.
Another unpleasant complication is a chronic pain syndrome that lasts more than 12 weeks and disturbs the psycho-emotional state of the patient.
Prevention
The following will help prevent the development and progression of lumbar osteochondrosis:
- regular physical activity, gymnastics;
- body weight control;
- warming up every hour when working in a sedentary position and staying in a stationary position for a long time;
- proper nutrition;
- visit the pool;
- yoga and pilates classes;
- abstinence from smoking and alcohol abuse;
- avoid heavy physical activity, especially heavy loads;
- minimize stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. The appointment of therapy in the early stages of the disease has a favorable prognosis for recovery. Early treatment stops degenerative processes and makes the patient's life painless and comfortable.