Lumbar spine osteochondrosis is a pathological change in the cartilage and bone tissue of the intervertebral discs in the lumbar spine. This change can be natural or it can be the result of an unhealthy lifestyle. In old age, processes of regression of bone and cartilage tissue begin in all people. But if these phenomena are premature (appear in middle-aged people), then we speak of pathological processes of the skeletal system. The pathology affects both men and women over 30 years of age.
Lumbar osteochondrosis is the best known and most common disease of the spine, which manifests itself as severe pain in the lumbar area. The disease is caused by metabolic disorders that lead to inadequate nutrition of the cartilage and bone tissue and accumulate waste products in the bone cells. This leads to pathologies of the intervertebral discs. In addition, their thickness and flexibility change, and then growths in the form of osteophytes (growth of bone tissue that narrow the holes for nerve endings) form on the vertebrae.
Reasons for the development of osteochondrosis of the lumbar spine
Lumbar spine osteochondrosis is much more common than thoracic or cervical osteochondrosis because the lower back is the most stressful when walking and running, sitting in a chair for long periods of time, or lifting weights.
Since this anatomical point absorbs the maximum load, its structure is very strong and reliable. The lumbar spine consists of five vertebrae and connects the rib cage with the sacrum. In between there are intervertebral discs that give the spine flexibility and mobility. The intervertebral discs, in turn, consist of a gelatinous core that is located in a hard annulus fibrosus. When osteochondrosis develops, the normal nutrition of the intervertebral discs is disrupted, as a result of which they become thinner, lose elasticity, and the distance between them decreases. This injures nerve roots, which leads to severe pain and even disability.
Therefore, the reasons for the development of this pathology are:
- Spinal injury;
- Diseases of the endocrine, digestive and cardiovascular systems;
- intense physical activity (lifting weights, running hard);
- sedentary lifestyle;
- disorders of the endocrine system;
- Flat feet;
- Disc abnormalities;
- high age;
- inflammatory diseases of the joints such as rheumatoid arthritis.
Risk factors for developing the disease are:
- stooping and poor posture;
- wrong lifestyle;
- unhealthy diet, obesity;
- being in the wrong posture for a long time;
- hereditary factor;
- emphasize;
- Hypothermia.
The main symptom of the disease is lower back pain. It can be felt immediately or after intense physical activity.
Other symptoms of lumbar osteochondrosis include:
- aching pain radiating to the lower back;
- increased pain after lifting weights, sneezing, coughing, moving the body;
- Stiffness in the body after a long time in one position;
- persistent spasms of the back muscles;
- sudden painful feeling (lumbago) after hypothermia;
- violation of sensitivity in the buttocks, thighs, lower legs and foot;
- paresis in the legs;
- Shivering of the feet;
- Spasm of the arteries of the feet;
- heavy sweating;
- Dryness and peeling of the skin in painful areas.
Lumbar spine osteochondrosis can be made worse by any awkward movement, such as moving or turning the body sideways. In this case, pain is noticed not only in the lower back, but also in the legs. There is also a strong spasm of the lumbar spasm as the body relieves this part of the body in this way. During an exacerbation, a person finds a comfortable position for himself in which the pain subsides.
One of the complications of lumbar spine osteochondrosis is malfunction of the genitourinary system. Sometimes there is increased urination and discomfort in the kidney area. Inflammation of the sciatic nerve and lumbodynia (lower back pain) can accompany the disease.
Stages of osteochondrosis of the lumbar spine
Unfortunately, osteochondrosis is an incurable disease and the process of destroying the intervertebral discs is irreversible. There are four degrees of development of osteochondrosis:
- The first degree at which the jelly-like core changes and moves within the intervertebral disc.
- The second degree is the period of destruction of the annulus fibrosus in the intervertebral disc;
- The third degree, at which the annulus fibrosus ruptures and the gelatinous core leaves, causing the formation of a herniated disc.
- The fourth degree is the phase of development of degenerative processes of the vertebrae with the involvement of intervertebral joints and ligaments. Osteoarthritis of the intervertebral joints (spondyloarthrosis) develops.
First degree
It is characterized by painful sensations due to irritation of the nerve endings in the annulus fibrosus and longitudinal ligaments. The patient feels pain and discomfort in the area of the affected intervertebral disc. The pain can be sharp, acute or dull, is permanent and localized in the lumbosacral segment. Very often it gives off on the leg, and sometimes it is only felt in the leg.
The irritation of nerve endings leads to the development of reflex syndromes. Because of this, a person does not always feel pain in the problem area, but far beyond it. There is also a violation of the robots of internal organs, the appearance of reflex muscle spasms; Circulatory disorders of the limbs and ligaments. Violation of blood circulation and nutrition of tendons and ligaments, which leads to pain and hardening of the attachment points of the bones.
Second degree
At this stage there is a characteristic instability and an increase in the mobility of the vertebrae, which leads to persistent lubrication of the muscles. At the same time, it is difficult for a person to stand, he feels discomfort and pain in the lower back. Sometimes the lower back "aches" and the patient does not understand why.
Third degree
It is characterized by the prolapse of fragments of the intervertebral discs, which is manifested by compression of the nerve roots. During this time, there is a violation of sensitivity in the zone of innervation of the compressed nerve. In addition, there are unpleasant sensations in the form of tingling, burning, numbness and a complete loss of sensitivity, which is accompanied by impairment of motor skills and sometimes leads to paralysis. Muscle atrophy, thinning and reduction are observed in the affected area. The zones in which the changes described above are observed eloquently indicate the location of the spinal lesion. A characteristic third-degree manifestation is the appearance of the Lasegue symptom. It is expressed as follows: when the patient lies on his back, the leg extended, there is severe pain in the lumbar area, which spreads along the back of the raised leg. When the legs are bent to the knees, the pain subsides immediately.
When fragments of intervertebral discs fall into the lumen of the spinal canal, damage to the spinal cord occurs. Another syndrome, the so-called ponytail, manifests itself in impaired sensitivity and motor skills of the legs as well as the pelvic organs and the bladder.
Fourth degree
This phase is characterized by the disappearance of the pain and the restoration of the function of the musculoskeletal system. At the same time, however, there is a restriction in motor function. The spine becomes wooden, so to speak, when disc fibrosis develops and all of its elements are replaced with dense scar tissue. At the same time, the ligaments and joints of the intervertebral vertebrae are involved in the inflammatory process, and different degrees of the disease are also observed, which is expressed in a polymorphism of symptoms.
How to treat lumbar spine osteochondrosis
Treatment for lumbar spine osteochondrosis is a very long and ongoing process. And above all, the successful treatment of a disease depends a lot on the person himself. After all, he will have to radically change his lifestyle and shed many everyday habits, as well as work on his health for the rest of his life.
In the opposite case, even successful drug treatment cannot completely eliminate the deformity of the spine. In addition, after a temporary improvement, symptoms return with a new intensity and treatment must be started over. Although sometimes, even with the observance of the regimen of physical activity, attacks of osteochondrosis occur.
Thus, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug treatment;
- not medicinal;
- Surgery.
Conservative drug treatment
Since osteochondrosis of the spine cannot be completely cured and is an irreversible process, the goal of conservative treatment is to eliminate symptoms and prevent further disease progression. Before starting drug treatment, it is necessary to minimize physical activity. Bed rest is recommended for severe exacerbations. This is sometimes more effective than medication.
To relieve symptoms of inflammation, use:
- NSAIDs (nonsteroidal anti-inflammatory drugs). The drugs of this group effectively eliminate pain and inflammation in the vertebrae. Medicines can be in the form of tablets or injections.
- Glucocorticosteroids. These drugs are classified as steroid hormones. Injections of glucocorticosteroids are given directly into the joint cavity. They are necessarily supplemented with B vitamins (B1, B6, B12).
- Sedatives. They are necessary to get rid of reflexogenic and related psychogenic disorders.
- Anticonvulsants. Eliminate involuntary skeletal muscle contractions.
- Antidepressants. The drugs of this group affect the level of neurotransmitters, due to which the patient's mood improves, melancholy, anxiety and emotional stress disappear.
- Diuretics. They are necessary when there are signs of radicular syndrome.
- Anticholinesterase drugs. Medicines in this group inhibit the activity of the enzyme cholinesterase, which increases the transmission of nerve impulses.
- Chondroprotectors. Is needed to prevent deformation of the intervertebral discs and joints.
For an acute attack, novocaine blockade is prescribed (the introduction of anesthetics directly into the affected area).
The symptoms of lumbar osteochondrosis in women are different from those in men. In women, the menstrual cycle can be disturbed, and gynecological diseases can also develop: inflammation of the ovaries and uterus (endometritis). Impairment of fertility can also occur. In this case, you need the help of a qualified gynecologist.
How to treat lumbar osteochondrosis at home
The main principle of home treatment is to eliminate symptoms that prevent a person from leading a quality lifestyle.
The following treatments are used at home:
- Diet. Very often the cause of osteochondrosis is the accumulation of cholesterol and the loss of vascular elasticity. A low-fat diet is required to provide relief. Also exclude from the diet foods high in cholesterol: eggs, pork, rich broths, chicken skin. Avoid alcohol and nicotine completely, reduce the consumption of coffee and strong tea. They lead to vasospasm.
- Restoration of blood supply to the lumbar region. To do this, use both rubbing with medicinal ointments and compresses, and physical therapy exercises that can be done at home.
- Orthopedic sleep aids. Since the spine is the axis of the human body that is subjected to enormous stress throughout the day, it needs adequate rest. This is the function of orthopedic mattresses and pillows, which are able to give the spine the correct position during sleep.