Lumbar osteochondrosis: causes, symptoms, diagnosis, treatment

Lumbar osteochondrosis is a dangerous disease of the spine, characteristic of people over 35 years of age. Natural wear and tear of the joints causes the development of pathology. Improper access to a rheumatologist in most cases leads to disability. Modern medicine offers many effective methods of treatment in the early stages. Early diagnosis is the key to a healthy life without limits.

Lumbar osteochondrosis - a general definition

Osteochondrosis of the lumbar spine is a dystrophic process of degeneration in the intervertebral cartilaginous formations - discs.

The discs provide the main functions of the spine - the ability to move and bend, resistance to stress. As a result of the pathology, important elements become thinner, deformed, the vertebrae are aligned, nerve endings and blood vessels are compressed. Negative processes are accompanied by pain sensations of varying intensity and limitation of motor function.

The pathology causes changes in the connecting elements of the spine - cartilage, bones, discs and joints. It is caused both by natural processes of wear and tear, and by acquired diseases of the joints or the result of an improper lifestyle.

Reasons

There can be many reasons for the development of lumbar osteochondrosis:

• Natural or premature wear of the body;
• Excessive strain on the lower back - lifting loads, working "on your feet" or sedentary, "sedentary" lifestyle;
• Genetic predisposition to joint diseases, such as rheumatoid arthritis;
• Disorder of metabolism, which leads to the accumulation of toxic substances in the connective discs;
• Chronic diseases of the circulatory system. Nutrients and trace elements cease to enter the cartilage tissue in the required amount. Hypoxia occurs, which contributes to the destruction of the intervertebral joints;
• Autoimmune pathologies.

Secondary factors can also provoke the development of lumbar osteochondrosis:

• Chronic injuries, bruises on the back;
• Overweight by more than 15-20%;
• Heavy or powerful sports;
• Constant wearing of uncomfortable shoes. High heels, tight shoes, rubber or sports shoes are the first enemies of the spine;
• Valgus changes in the foot;
• Scoliosis, kyphosis, diabetes mellitus, spinal tuberculosis;
• Influence of low temperatures.

Clinical picture

The symptoms of lumbar osteochondrosis completely depend on which nerve roots are affected by the disease. The degree of compression of the vertebrae, the stage of the disease and the damage to the disc determine the signs.

Rheumatologists distinguish the following main symptoms:

• Impaired tactile sensitivity in the lumbar region. The tingling extends to the inner thighs and groin. May affect one or both limbs;
• There is a sharp, shooting pain in the lower back. The big toe completely loses mobility and characteristic tingling is observed;
• Loss of normal function of the foot, sensitivity of the toes, lower leg and outer thigh. There is tone and regular seizures in these parts of the legs. On examination there is no Achilles' reflex;
• If the disease affects the lower radicular artery, then there is complete paralysis of the muscles of the buttocks, back of the thighs and perineum. There is a serious impairment of motor function, up to complete immobility.

Lumbar osteochondrosis affects not only the nerve endings of the spine, but also the blood vessels.

The following specific signs depend on the type of lesion:

• When only the nerve roots are disturbed, a change in the patient's gait is observed. The pain is localized not only in the lumbar region, but also in all parts of the legs. Radicular syndrome is characterized by constant pain. Usually only on one side. Numbness and pain are noted in the lower back. The pain can be relieved with a little exercise.
• Compression of blood vessels leads to perfusion in the hip joint. As a result, oxygen starvation of the spinal discs occurs. Painful sensations occur when walking in the buttocks, thighs and lower back. It is completely removed after a night's rest.

Simultaneous dysfunction of blood vessels and nerve roots can lead to irreversible deformation of the discs. Prickly bone growths form in the movable joints of the lower back. This causes severe pain and makes normal natural movement impossible. Impaired posture, gait. As it progresses, complete paralysis can occur.

Stages of the disease

Lumbar osteochondrosis develops gradually, in several stages. Each stage has its own characteristics that determine the degree of progress.

• I stage.Slow destruction of the intervertebral discs begins. The process can last from several months to 2-5 years. Manifested by mild pain, discomfort in the inguinal and thigh muscles. It is noticed when walking or when changing the time.
• Stage II. The collagen fibers of the fibrous rings of the spine are attracted to the negative process. The space between the individual vertebrae shrinks rapidly. Friction occurs, which causes severe attacks of pain. Impaired gait, posture, stooping appear. Lumbar osteochondrosis is most often diagnosed in the second stage of the course.
• Stage III.An intervertebral hernia occurs. And if the patient has not been forced to seek medical help with stage II symptoms, then it will no longer be possible to ignore the excruciating pain of stage three. The deformation of the bones and joints of the spine in the lumbar region is now irreversible. Walking takes a lot of effort. This is due to the pain and inability to relieve it with conventional painkillers.
• Stage IV.Partial or complete impairment of motor function. At this stage, the patient is assigned a disability group. Threat of complete paralysis. Life activity is impossible without taking a wide range of drugs.

Diagnostic measures

Diagnostic measures include several techniques and begin with a complete history of the disease. During the initial consultation with a rheumatologist, the following data are specified:

1. The patient's complaints are carefully analyzed - the place of localization of pain, where discomfort is still felt, in which parts of the hip joint there is a feeling of heaviness, convulsions, etc. ;
2. Duration, regularity, nature of the pain;
3. When the first, even insignificant symptoms appeared. How much time has passed since the last attack, what causes discomfort and what factors contribute to its elimination;
4. The patient's living conditions. Profession, work, household workload, sports and the presence of additional factors for increased physical activity (dacha, garden, hobbies related to weight transfer);
5. Research the history of diseases that the patient has suffered in the past or present.

After collecting the clinical picture, the rheumatologist proceeds directly to the external examination. The examination analyzes the gait, the anatomical position of the legs, arms, torso, relative to the spine. The skin is examined for changes - pigmentation, scaling, eczema, rashes and more. Assessment of motor function is given.

Performing simple exercises - leaning forward, backward, lifting arms and legs, turning the head, rotational movements of the pelvis, the patient allows the doctor to determine the degree of damage to the spine in the lumbar region.

The latest measures of the external review are actions to determine the degree of radicular damage:

• Lasegue symptom.Lying on his back, the patient raises his legs successively, bent at the knee. If this causes pain in the lower back, then the indications are considered positive.
• Degerin's symptom.The patient is required to tighten the abdominal muscles as much as possible. The appearance of discomfort in the spine indicates the development of lumbar osteochondrosis.
• Neri's symptom. Sharp tilts of the head back and forth respond with low back pain.
• Wasserman's symptom. The patient, lying down, move his legs to the side as much as possible. In the presence of pathology, unpleasant pain appears in the groin and front of the thigh.

To confirm or rule out the diagnosis, the patient is invited to undergo an instrumental diagnosis. MRI is considered to be the most effective way to determine lumbar osteochondrosis. The study shows the distance between the vertebrae, the development of tumors and bone deformities. It can be contraindicated in patients with mental disorders.
Computed tomography gives a fairly accurate picture of the disease in one plane - horizontal or vertical.
The X-ray is used only in the last stages, when irreversible changes in the bone tissue of the spine begin.

Complex treatment of lumbar osteochondrosis

The causes of the pathology are not fully understood. Research in the field of joint diseases of the spine has not yet identified sufficiently effective methods for complete recovery of the intervertebral discs. Modern methods of treatment are aimed only at eliminating the external signs of the disease. At present, full recovery is considered impossible.

Traditional drug therapy

The rheumatologist prescribes medication, depending on the general condition of the patient. The clinical picture provides the necessary information for drawing up a treatment plan with drugs from several groups.

1. Anesthetics.Injections, ointments or broad-spectrum drugs are prescribed.
2. Anti-inflammatory drugs (NSAIDs).
3. Vasodilators.Removal of tone from the muscles of the lumbar region and legs.
4. Chondroprotectors.Designed to rule out the negative progression of lumbar osteochondrosis.

Physiotherapy

Physiotherapy procedures are an integral part of inpatient or outpatient treatment of lumbar osteochondrosis.

Includes the following activities:

• Electrophoresis with analgesics;
• Magnetic therapy;
• Hydrotherapy;
• Paraffin applications.

The drug and physiotherapy in the complex relieve acute pain and inflammation. But they are not a guarantee to stop the development of pathology. Only a course of treatment 2-3 times a year and a responsible attitude of the patient will help to avoid regression and keep the general condition in satisfactory shape.

Exercise therapy and therapeutic massage

A set of exercises from therapeutic gymnastics provides normalization of blood circulation in the lower back and helps to eliminate stagnant processes. Only a physiotherapist can prescribe exercises for clinical or home use. As a rule, these are all kinds of soft inclines and rotational movements, from lying down and sitting. Physical activity alone can not only not work, but can cause even more displacement of the spinal discs.

Manual therapy sessions help strengthen muscle tissue, blood flow to the affected lower back and relieve tension. The specialist massages first a healthy part of the back, to warm the muscles and improve blood circulation. It then goes to the affected areas of the lumbar region. The manipulation area includes the lower back, buttocks, thighs, shins and feet. The sessions are held in regular courses, at least 10 sessions every 6 months.

Surgical intervention

It is indicated in the last stage of lumbar osteochondrosis to restore motor function of the spine. Surgery remains the only option for patients who have the following symptoms:

• Persistent pain syndrome, incurable even with opiate-containing drugs;
• Strong compression of the nerve roots and significant displacement of the discs;
• Neoplasms, bone proliferation;
• Complete destruction of the vertebrae due to constant friction;
• paralysis.

Modern methods offer less traumatic methods of internal intervention. For example, endoscopy. It has a favorable prognosis, a short rehabilitation period and a low rate of side effects.

Alternative treatment

Lumbar osteochondrosis responds well to treatment with medicinal herbs and folk methods. Ointments, tinctures, baths based on fees are used to relieve swelling and pain. The most effective recipes include anesthetic and anti-inflammatory herbs:

• yarrow;
• aloe;
• mint;
• St. John's Wort;
• Spruce or pine needles;
• sage.

The content of these herbs in folk recipes is due to their healing effect, scientifically proven by traditional medicine. Treatment at home will help keep the lower back in a stable condition and will prevent exacerbation of the disease after complex treatment.

Prevention

Despite the fact that lumbar osteochondrosis is an incurable disease, its negative effects can be minimized. In the early stages of the disease is treated successfully, it is only necessary to seek medical help in a timely manner. It is important to fully adhere to the established treatment regimen and follow the recommendations of the rheumatologist.