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 the elderly are susceptible to the disease. But in recent years, this diagnosis is increasingly being made in young people and even in children. If osteochondrosis is not treated, serious complications can develop.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used to get rid of pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral and many at the same time. But more often it affects the lumbosacral region. This is due to the fact that the lower back bears the greatest load when performing even simple daily activities: 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 heavier load, makes it a favorite "target" of osteochondrosis.
Initially, the pathology concerns the intervertebral discs, which lose their elasticity, become "dry" and decrease in height. The shock-absorbing function is disrupted, causing the vertebrae to move closer to each other. The inner part of the intervertebral disc, called the pulposus, because of its softness, begins to swell, pushing aside the annulus fibrosus that is around it. This is how protrusions and hernias 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. But the fact that the disease is often diagnosed in representatives of certain groups suggests that lifestyle has a great influence on the development of the disease. First of all, this affects people with a lack of physical activity and sedentary work. A passive lifestyle weakens the muscular corset and reduces the mobility of the spine. Because of this, the muscles lose the ability to hold the spine in the correct physiological position, which leads to its rapid wear and tear.
The main risk factors for developing osteochondrosis include:
- frequent lifting of heavy objects.
- overweight, obesity;
- endocrine diseases, hormonal imbalance.
- poor diet, insufficient intake of vitamins, proteins and minerals.
- burdened heredity;
- excessive physical activity;
- back injuries;
- posture disorders;
- inflammatory diseases of the joints: arthritis, arthritis.
- congenital anomalies of the spine.
- flatfeet;
- pregnancy, especially multiple pregnancy.
Symptoms
The insidious thing about osteochondrosis is that it can be asymptomatic for many years. At first it is a slight pain and discomfort in the lower back, which goes away on its own after a short rest. Usually, patients do not pay attention to these signs and do not consult a doctor. Gradually, however, the intensity of the unpleasant sensations increases and to relieve them more rest or painkillers are required.
Low back pain with osteochondrosis is the main symptom of the pathology. Its nature, severity and location can vary greatly - it depends on what exactly is causing the pain. Most often, patients complain of aching pain, which intensifies during physical activity, prolonged standing in a position, sneezing and coughing. Sometimes the pain spreads to the leg, sacrum and buttocks. Unpleasant sensations subside in a supine position. Often sharp and sharp pain is described by patients as "shooting in the back".
Other common complaints:
- stiffness and tension in the back muscles.
- reduced sensitivity in the lower extremities of varying severity, "goosebumps" crawling feeling in the legs.
- limited mobility of the spine.
- change in gait, lameness due to severe back pain or leg pain.
- muscle weakness in the legs.
- Rachiocampsis;
- cramping in the back when bending or twisting;
- urinary and fecal incontinence or, conversely, constipation and urinary retention.
Symptoms of lumbar osteochondrosis in women can be supplemented by some gynecological diseases and infertility, and in men - infertility and erectile dysfunction.
Diagnostics
The diagnosis of lumbar osteochondrosis begins after 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 performs:
- Overview.The specialist clarifies the complaints, the time of their appearance and the existence of a connection with provoking factors: physical activity, prolonged static posture, sudden movement, hypothermia. He also studies the medical documentation - doctors' opinions and the results of previous examinations.
- Inspection. The doctor examines the skin and spine for visible injuries, lesions and deformities. Assesses gait and limb symmetry.
- Palpation. Palpation of the spine reveals pain, the presence of compacts or deformations.
- 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.
After that, the patient is referred for a more detailed diagnostic examination. To assess the condition of the body, laboratory tests are prescribed:
- general and biochemical blood test, including evaluation of inflammatory markers - ESR and C-reactive protein.
- general urinalysis.
Intervertebral osteochondrosis of the lumbar region is confirmed by instrumental diagnostic methods:
- X-ray in two views. An X-ray image helps to assess the condition of the bones, identify abnormalities in the development of the spine, detect formed osteophytes and pathological changes in the joints.
- CT. A layer-by-layer CT image makes it possible to study the spine in more detail. It visualizes vertebrae, bony growths and other major defects. Computed tomography with intravenous contrast shows the condition of the blood vessels and blood circulation in the tissues.
- MRI. The preferred diagnostic method as it allows you to get a large amount of accurate information quickly and without radiation. An MRI image depicts the condition of the cartilage, ligaments, intervertebral discs, spinal nerve roots, spinal cord and other soft tissues.
Which doctor should I contact?
The diagnosis and treatment of osteochondrosis is carried out by doctors of various specialties: neurologist, spondylologist, orthopedic traumatologist. A physiotherapist, masseur, acupuncturist and physiotherapist are involved in the therapeutic procedures. Doctors of all 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 immediately seek professional help. Many people do not know why lumbar osteochondrosis is dangerous and how it can affect daily life. If this disease is ignored, serious and often irreversible health consequences can occur. 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, only a qualified doctor can say. Self-medication is strictly contraindicated - this can worsen 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,
- period of pregnancy and lactation.
Treatment methods for osteochondrosis of the lumbar spine:
- Pharmacotherapy.
The type of medicine, dosage, frequency and duration of its administration are chosen by the doctor. Depending on the clinical case, the following are prescribed:
Non-steroidal anti-inflammatory drugs. They have anti-inflammatory and analgesic effects. They are prescribed taking into account the severity of pain and accompanying pathologies, especially from the gastrointestinal tract and cardiovascular system.Muscle relaxants. Eliminate back muscle strain and reduce pain.Glucocorticosteroids. It is sometimes used for severe pain and inflammation.
In cases of severe pain, drug blockades may be prescribed. The procedure involves injecting painkillers and anti-inflammatory drugs directly into the source of the pain - a spot next to 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, enhance the effect of prescription drugs and accelerate tissue regeneration. For osteochondrosis the following are recommended:
- shock wave therapy,
- magnetotherapy,
- laser treatment.
In order to achieve the maximum therapeutic results, it is necessary to undergo a course of physiotherapy treatment consisting of various procedures. The doctor determines the duration and frequency of physical therapy individually.
- Massage therapy.
The massage is indicated outside the peak period. It is carried out by a qualified massage therapist who chooses the tactic of influencing the body taking into account the medical history. You may feel better after the first session, but several procedures are needed for lasting results. One of the main advantages of therapeutic massage is its additional effect on the psycho-emotional state. During a massage, endorphins - hormones of pleasure and joy - are released.
- Acupuncture.
The essence of acupuncture is that the doctor inserts special sterile needles into certain parts of 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 relieve pain, relax muscles and improve spinal mobility.
- Therapeutic physical therapy (physiotherapy).
Exercise therapy is indicated during the period of remission, i. e. when there is no acute pain. The exercises are aimed at stretching and relaxing the spinal muscles, strengthening them and increasing the mobility of the spinal joints. Therapeutic gymnastics increases blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and correct physical therapy, even at home, prevents the exacerbation of the disease and the occurrence of a pain crisis. And even in periods of acute pain, bed rest is contraindicated; it is necessary to move.
Concequenses
The most common consequences of lumbar osteochondrosis are caused by a formed hernia that compresses the spinal nerve roots. As a result, the following neurological symptoms appear:
- paresis or paralysis of the lower limbs, more often the legs.
- numbness, crawling sensation in lower extremities.
- disorder of the genitourinary system and intestines.
A large hernia can compress the spinal cord, which is called disc myelopathy. In this case, persistent neurological symptoms develop, which sometimes lead to disability. Also, among the complications of osteochondrosis, it is worth highlighting spondylosis - 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 the chronic pain syndrome, which 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.
- weight control;
- warm-up every hour when working sedentary and standing still for a long time.
- proper nutrition?
- visit to the pool;
- yoga and pilates classes.
- cessation of smoking and alcohol abuse;
- avoiding heavy physical activity, especially lifting heavy weights.
- minimizing stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. Prescribing treatment in the initial stages of the disease has a favorable prognosis for recovery. Early treatment stops the degenerative processes and makes the patient's life painless and comfortable.