Spinal osteochondrosis 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 to young people and even 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 help relieve pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral, and several simultaneously. But most often it affects the lumbosacral region. This is due to the fact that the lower back bears the heaviest load when performing even simple everyday activities: lifting heavy objects, walking, running, sitting. The 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 affects the intervertebral discs, which lose their elasticity, "dry out" and decrease in height. Its shock absorption function is altered, causing the vertebrae to move closer together. The internal part of the intervertebral disc, called the nucleus pulposus, due to its softness, begins to bulge, pushing the annulus fibrosus that is around it to one side. This is how bulges and hernias form. They can compress the longitudinal ligaments of the spine and the roots of the spinal nerves, causing pain.
Causes
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 maintain the spine in the correct physiological position, which causes their rapid wear and tear.
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 inheritance;
- excessive physical activity;
- back injuries;
- posture disorders;
- inflammatory diseases in the joints: arthritis, osteoarthritis;
- congenital anomalies of the spine;
- flatfoot;
- 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 disappears on its own after a short rest. Typically, patients do not pay attention to these signs and do not consult a doctor. But little by little the intensity of the unpleasant sensations increases and to relieve them it is necessary to rest more or take a pain reliever.
Low back pain with osteochondrosis is the main symptom of the pathology. Its nature, severity and location can vary greatly; It depends on the exact cause of the pain. Most often, patients complain of aching pain, which intensifies during physical activity, when standing for a long time in a stationary position, sneezing and coughing. Sometimes the pain extends to the leg, sacrum, and buttocks. Unpleasant sensations disappear in the supine position. Often, patients describe the sharp, sharp pain as a "shot in the back. "
Other common complaints:
- stiffness and tension in the back muscles;
- altered sensitivity in the lower extremities of varying severity, sensation of "goosebumps" on the legs;
- limited mobility of the spine;
- change in gait, limping due to severe back pain or leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- cracking in the back when bending or twisting;
- urinary and fecal incontinence or, conversely, constipation and urinary retention.
The symptoms of lumbar osteochondrosis in women can be complemented by some gynecological diseases and infertility, and in men - by infertility and erectile dysfunction.
Diagnosis
Diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. Additionally, instrumental and laboratory examination methods are carried out to assess the condition of the spine and the body as a whole.
At the initial consultation, the doctor performs:
- Survey.The specialist clarifies the complaints, the time of their appearance and the presence of a connection with provoking factors: physical activity, prolonged static posture, sudden movements, hypothermia. He also studies medical documentation: medical reports and results of previous examinations.
- Inspection. The doctor examines the skin and spine for visible injuries, damage, and deformities. He evaluates the gait and symmetry of the limbs.
- Palpation. During palpation of the spine pain, presence of compactions or deformities are revealed.
- Neurological examination. Consultation with a neurologist necessarily includes an assessment of the muscle strength of the extremities, the sensitivity in them and the symmetry of tendon reflexes.
After this, the patient is referred for further diagnostic examination. To assess the state of the body, laboratory tests are prescribed:
- general and biochemical blood tests, including assessment of inflammatory indicators: ESR and C-reactive protein;
- general urine analysis.
Intervertebral osteochondrosis of the lumbar region is confirmed by instrumental diagnostic methods:
- Radiography in two projections.. 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.
- Connecticut. A layer-by-layer CT image allows the spine to be studied in more detail. Visualize vertebrae, bone growths and other important defects. CT scan with intravenous contrast shows the state of blood vessels and blood circulation in tissues.
- magnetic resonance. The preferred diagnostic method, as it allows a large amount of accurate information to be obtained quickly and without radiation. An MRI image visualizes the condition of the 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: neurologist, vertebrologist and orthopedic traumatologist. The therapeutic procedures involve a physiotherapist, a masseuse, an acupuncturist and a physiotherapy specialist. Doctors from all these specialties work in the 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 help from professionals. Many people do not know why lumbar osteochondrosis is dangerous and how it can affect everyday life. If this disease is ignored, serious and often irreversible health consequences can occur. 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
What to do with lumbar osteochondrosis in men and women, only a qualified doctor can tell. Self-medication is strictly contraindicated; This can aggravate the course of the disease. The doctor chooses 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.
Treatment methods for osteochondrosis of the lumbar spine:
- Drug therapy.
The doctor selects the type of medication, its dosage, frequency and duration of administration. Depending on the clinical case, the following is prescribed:
- Non-steroidal anti-inflammatory drugs.They have anti-inflammatory and analgesic effects. They are prescribed taking into account the severity of pain and concomitant pathologies, especially of the gastrointestinal tract and cardiovascular system.
- Muscle relaxants.Removes tension from back muscles and reduces pain.
- Glucocorticosteroids.It is sometimes used for severe pain and inflammation.
In cases of severe pain, it is possible to prescribe pharmacological blocks. The procedure consists of injecting analgesics and anti-inflammatories directly into the source of the pain, at a point located next to the compressed nerve. This allows you to quickly relieve pain, improve the mobility of the joints of the spine and the general well-being of the patient.
- Physiotherapy.
Physiotherapeutic procedures improve well-being, enhance the effect of prescribed medications and accelerate tissue regeneration. For osteochondrosis, the following is recommended:
- shock wave therapy,
- magnetotherapy,
- laser therapy.
To achieve maximum therapeutic results, it is necessary to undergo physiotherapy treatment consisting of several procedures. The duration and frequency of physiotherapy is determined by the doctor on an individual basis.
- Massage therapy.
Massage is indicated outside the exacerbation period. It is performed by a qualified masseuse who chooses the tactics of influencing the body taking into account the medical history. You may feel better after the first session, but several procedures are needed to achieve long-lasting results. One of the main advantages of therapeutic massage is its additional impact 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 points on the body. They act on active points in the projection of nerve endings that lead to the origin of inflammation and pain. The method helps relieve pain, relax muscles and improve spinal mobility.
- Therapeutic physical education (physiotherapy).
Exercise therapy is indicated during the period of remission, that is, when there is no acute pain. The exercises are aimed at stretching and relaxing the muscles of the spine, strengthening them and increasing the mobility of the joints of the spine. Therapeutic gymnastics increases blood circulation and stimulates metabolism, which improves tissue nutrition.
Regular and adequate physiotherapy, including at home, prevents exacerbation of the disease and the onset of a pain attack. And even during periods of acute pain, bed rest is contraindicated, it is necessary to move.
Consequences
The most common consequences of lumbar osteochondrosis are caused by a hernia formed that compresses the roots of the spinal nerves. As a result, the following neurological symptoms occur:
- paresis or paralysis of the lower extremities, most often the feet;
- numbness, tingling sensation in the lower extremities;
- disturbance of the genitourinary system and intestines.
A large hernia can compress the spinal cord, called discogenic myelopathy. In this case, persistent neurological symptoms develop, sometimes leading to disability. Also among the complications of osteochondrosis, spondylosis should be highlighted, which is the stiffness of the joints between the vertebral arches. The disease leads to a strong limitation of spinal movements.
Another unpleasant complication is chronic pain syndrome, which lasts more than 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;
- body weight control;
- warm up every hour when working sedentarily and staying in a stationary position for a long time;
- proper nutrition;
- visit the pool;
- yoga and pilates classes;
- quit smoking and alcohol abuse;
- avoid strenuous physical activity, especially lifting heavy objects;
- minimizing stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. Prescribing therapy in the initial stages of the disease has a favorable prognosis for recovery. Early treatment stops degenerative processes and makes the patient's life comfortable and pain-free.