Osteochondrosis is a widespread disease of the spine, affecting the intervertebral discs and cartilage. The cervical and lumbar regions are most susceptible to such processes. Osteochondrosis of the lumbar region can cause constant pain in the lower back and significantly complicate a person's life. In the treatment of the disease, preference is given to conservative methods, surgical interventions are resorted to only in extreme cases.
Causes of lumbar osteochondrosis
Osteochondrosis is not so much a disease as often a natural phenomenon that occurs due to age-related degenerative changes in the spine. Normally, the disc in the lumbar spine acts as a shock absorber between two vertebrae and allows the joints and spine to move easily. The outer part of the disc, the annulus fibrosus, surrounds the soft inner core of the disc, the nucleus pulposus. Every person's spinal discs undergo degenerative changes with age, but not everyone develops symptoms.
It is believed that osteochondrosis begins with changes in the fibrous ring, intervertebral disc and subchondral bone. The fibrous ring loses water, which makes it less able to withstand daily loads on the spine, distributing them incorrectly. Overload of the posterior part of the vertebra leads to arthritis of the facet joints and hypertrophy (growth, with the formation of osteophytes - bony outgrowths) of the vertebral bodies adjacent to the affected disc.
Reference! According to statistics, 30% of people between the ages of 30 and 50 have some degree of spinal disc degradation.
There are two main pathophysiological causes of pain in lumbar osteochondrosis. One of the possible causes of pain is inflammation of the nerves due to the rupture of the external part of the disc and the leakage of the internal nucleus. Inflammatory proteins are released that irritate nervous tissue.
According to the second reason, the vertebrae, due to age-related deformation, are no longer able to effectively absorb the load. This causes abnormal movements of the spine and causes a painful spasm of the back muscles that try to stabilize the spine.
The outcome of osteochondrosis can be the destruction of segments of the spine, leading to radiculitis. The risk factors that trigger and accelerate degenerative processes in the spine are:
- Hereditary predisposition to diseases of the musculoskeletal system;
- To smoke;
- previous injuries;
- Hormonal and vascular disorders;
- Excess body weight;
- Muscles that are too weak and do not provide the necessary support to the spine;
- Professional activities associated with heavy physical work (athletes, loaders).
Stages of development of lumbar osteochondrosis
Disorders of the intervertebral discs, leading to their degeneration and destruction, occur gradually. The entire pathological process goes through several stages, according to which the stages (or degrees) of lumbar osteochondrosis are distinguished:
- The first stage (grade) is characterized by mild symptoms. Painful sensations develop against the background of irritation of the nerve endings by the nucleus pulposus, penetrating into the cracks of the fibrous ring.
- The second stage is characterized by the displacement of the upper vertebra compared to the lower one, due to the rupture of the nucleus and the ring. These pathological processes, in addition to pain during movement, cause the appearance of neurological symptoms, sensations of numbness and instability in the affected area.
- The third stage is characterized by increased pain and the appearance of intervertebral disc herniations, due to violation of the integrity of the fibrous ring. Pain, sensory impairment, and muscle weakness interfere with daily activities. Due to crushing of the nerve roots, the functioning of the urinary and intestinal systems can be disrupted.
- The fourth stage corresponds to the complete destruction of the intervertebral discs, they become fibrotic, and osteochondral growths of the vertebral bodies cause immobility of the spine in this section.
Symptoms of lumbar osteochondrosis
To get started, ask the specialists for advice:
- Neurologist
- Orthopedic
- Therapist
The main symptom of lumbar and sacral osteochondrosis is pain. It typically worsens when sitting for long periods of time or when twisting, bending the spine, or lifting a load. The pain may radiate to the leg, groin and be accompanied by a feeling of numbness and weakness. Moderate, aching, dull pain may be followed by attacks of exacerbation.
Symptoms directly depend on the stage of development of the pathology:
- In the early period, when degenerative changes are just beginning to appear, symptoms are minimal.
- The intermediate stage, characterized by the weakening of the fibrous ring, can already manifest itself as low back pain.
- In the later stage, when fibrosis develops in the structures and osteophytes are formed, the pain becomes less pronounced, but the mobility of the spine decreases significantly.
The sensitivity of the lower back may increase when touched. The characteristic shooting pains in the buttocks, thighs and tingling sensation are a sign of pinched nerve roots that occur due to degenerative changes in the disc. Patients with lumbar osteochondrosis have difficulty bending forward, backward and sideways. Osteochondrosis can be complicated by herniated disc and narrowing of the spinal canal, accompanied by the appearance of additional symptoms.
Diagnosis of lumbar osteochondrosis
Making a diagnosis begins with taking the medical history, interviewing and examining the patient. The specialist will be interested in your complaints, physical activity, the presence of old injuries, bad habits and cases of illness in close relatives. During a physical exam, your doctor palpates (feels) the lower part of your spine, looking for areas of pain, inflammation, or any abnormalities. He can also check sensitivity and perform motor tests.
The most popular method of diagnosing lumbar osteochondrosis is X-ray examination. The image will show the presence of osteophytes, narrowing of the joint space of the disk or the so-called "void" symptom, when gas bubbles are detected in the thickness of the disc. Other methods used are:
- MRI shows hydration (the degree of saturation with water), the shape of the discs, their height, which allows you to identify pinched nerves.
- CT scan, which allows you to study the state of tissues in detail and diagnose disorders in the early stages.
- Provocative discography used to determine the location of the affected disc.
Reference! MRI is a fairly accurate diagnostic method, but it cannot detect rupture of the outer rings of the disc.
Methods of treatment for lumbar osteochondrosis
The preferred treatment for lumbar degenerative disc disease associated with chronic pain is conservative treatment with physical therapy, exercise, and medications. For patients with lumbar osteochondrosis it is recommended:
- A daily routine that includes sufficient rest and adequate physical activity;
- Regular physical exercise aimed at strengthening muscles;
- Lifestyle adjustments, including nutritional review and weight loss.
Physiotherapy
Various physiotherapeutic techniques have been used successfully to reduce low back pain. Physiotherapy promotes the regenerative processes of the disc, stimulates metabolic and transport processes, prevents the formation of adhesions and further damage.
Physiotherapy methods used to treat spinal osteochondrosis include:
- Electrical stimulation. The electrical impulses help relieve back pain and improve blood circulation in the affected spine.
- Ultrasound therapy. Ultrasonic waves can penetrate deep tissue layers and help relieve inflammation and pain.
- Magnetotherapy. Magnetic fields can improve blood circulation and metabolic processes in tissues, promoting their regeneration.
- Laser therapy. Laser beams can help relieve pain, stimulate blood circulation and stimulate tissue regeneration.
- Ultraphonophoresis. This method combines ultrasound therapy with the use of drugs that penetrate into the deep layers of tissues and help relieve inflammation and pain.
Important! Contrary to popular belief, osteochondrosis can and should be treated. Without treatment, it will become a source of chronic pain and can lead to numerous problems, including disruption of the functioning of internal organs.
Pharmacological treatment
To relieve pain that interferes with daily activities, patients are prescribed analgesics and nonsteroidal anti-inflammatory drugs. According to indications, the doctor may prescribe stronger drugs: muscle relaxants, steroids and narcotic painkillers. Therapeutic blocks are administered with local anesthetics and glucocorticoids to relieve severe pain.
Surgery
Much less frequently, surgical intervention is used for osteochondrosis of the lumbar region. It may include disc arthroplasty or fusion of the lumbar spine (creating conditions for the fusion of two vertebrae, while pain is reduced by eliminating movement in this part of the spine).
If the movement of the spine is significantly impaired, special intervertebral spacers can be installed. For patients who do not respond to all other treatments, a total lumbar disc replacement may be performed.
Treatment of lumbar osteochondrosis at home
The most effective thing you can do at home to maintain function and control pain is to exercise. They will increase the flow of blood, oxygen and nutrients to the spine, helping to keep the cartilage hydrated and the spine flexible for as long as possible. Furthermore, endorphins, which are natural painkillers, are released during physical activity.
Frequent changes in position also bring relief. Some poses help to cope with a pain attack: kneeling, lying down, lying down. A short rest is necessary and beneficial, but prolonged bed rest only worsens the condition. It is important to stay active to prevent the disease from progressing. Patients suffering from lumbar osteochondrosis benefit from walking, swimming, cycling, yoga, pilates, stretching exercises and strengthening the muscle corset. The following measures also help:
- Applying heat to the lower back improves blood circulation and relieves muscle spasms and tension.
- Ice packs will help relieve pain and reduce inflammation.
- Massage also relaxes muscles, relieves spasms and reduces pressure on the spine, thus relieving pain. By increasing blood circulation in this area, metabolic processes are improved and tissues are enriched with oxygen.
- Use of orthopedic mattresses and pillows. They will help maintain the correct position of the spine during sleep.
- Correct distribution of load on the spine. When lifting heavy objects, you must use proper lifting technique to avoid placing strain on your lumbar spine.
- Appropriate nutrition. Eating a balanced diet rich in calcium and vitamins will help maintain healthy bones and joints.
However, if you experience pain or other symptoms, before starting treatment for osteochondrosis at home, you should consult your doctor to receive more precise advice and evaluate the condition of your spine.
Which doctor should I contact for lumbar osteochondrosis?
If symptoms characteristic of lumbar osteochondrosis appear, it is recommended to consult a neurologist or orthopedic doctor. If you suffer from back pain, you can also make an appointment with a therapist. He will prescribe the necessary tests to make the diagnosis and will refer you to a specialist.
Treatment of lumbar osteochondrosis
Specialists of the nearest clinic in your city or other locality are ready to understand the reasons and help you cope with the pain. Doctors usually have extensive clinical experience and master all modern methods of treatment and diagnosis of osteochondrosis in women and men. For the most part, convenient location, excellent equipment and versatility of institutions are a priority of modern medicine, which allow you to quickly undergo any examination and restore the health of the musculoskeletal system. You can make an appointment by calling the clinic most convenient for you, as well as on the website by filling out the online form.
Prevention of lumbar osteochondrosis
Effective methods to prevent lumbar osteochondrosis are:
- Regular physical activity. Keep in good physical shape. Strengthens your back muscles. Stretching and strengthening exercises for your back will help keep your spine healthy.
- Reduce stress on the spine: Avoid unnecessary stress on the spine. When lifting heavy objects, use proper lifting technique.
- Posture correction: ensure correct posture. Sit down and stand straight, don't slouch. Choose a pillow and an orthopedic mattress for sleeping to maintain the correct position of the spine during rest. Buy quality shoes with good cushioning and support.
- Take care of back support by using orthopedic chairs if, due to the nature of your profession, you are forced to sit for long periods of time. Avoid staying in the same position for a long time. Take regular breaks and stretch your spine.
- Watch your weight. Excess weight can cause additional stress on the spine.
- Avoid uncontrolled movements and back injuries. Be careful when playing sports or physical activity.
- Stop smoking, as it can negatively affect spinal health.
By following simple advice, you can live an active and fulfilling life, minimizing the risks of back pain. If you already have symptoms, lumbar spine pain, be sure to see a doctor for diagnosis and treatment.