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 has been made more and more often 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 relieve pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral and more at the same time. But it most often affects the lumbosacral region. This is due to the fact that the lower back bears the greatest load even during simple daily activities: lifting heavy objects, walking, running, sitting. The lumbar vertebrae are the largest, so the discs that separate them are also the largest. The lumbar region, together with the cervical region, is the most mobile part of the spine. This fact makes it a favorite "target" of osteochondrosis under the greatest load.
Initially, the pathology concerns the intervertebral discs, which lose their elasticity, "dry up" and decrease in height. Their shock-absorbing function is interrupted, due to which the vertebrae become closer to each other. The inner part of the intervertebral disc, the so-called nucleus pulposus, begins to bulge due to its softness, pushing aside around itfibrous annulus. This creates protrusions and hernias. They can compress the longitudinal ligaments of the spine and spinal nerve roots, causing pain.
Cause
The exact cause of osteochondrosis is unknown. But the fact that the disease is often diagnosed in representatives of certain groups suggests that lifestyle greatly influences the development of the disease. This primarily affects people suffering from a lack of physical activity and sedentary work. A passive lifestyle weakens the ligaments and reduces the mobility of the spine. Because of this, the muscles lose their ability to hold the spine in the correct physiological position, which leads to rapid wear and tear.
The main risk factors for the development of osteochondrosis are:
- 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, arthrosis;
- congenital abnormalities of the spine;
- goose feet;
- pregnancy, especially multiple pregnancy.
Symptoms
The insidiousness of osteochondrosis is that it can be asymptomatic for many years. At first, there is a slight pain and discomfort in the lower back, which goes away on its own after a short rest. Patients usually do not pay attention to these signs and do not consult a doctor. But gradually the intensity of unpleasant sensations increases, and to relieve them, more rest or taking painkillers is required.
Lower back pain associated with osteochondrosis is the main symptom of the pathology. Its nature, severity and location can be very different - it depends on what exactly is causing the pain. Most often, patients complain of aching pain, which intensifies during physical activity, prolonged standing, sneezing and coughing. Sometimes the pain spreads to the legs, sacrum and buttocks. Unpleasant feelings go away in a lying position. Acute and sharp pain is often described by patients as a "shot in the back".
Other common complaints:
- stiffness and tension in the back muscles;
- sensitivity of the lower limbs of varying severity, feeling of "goosebumps" crawling up the legs;
- limited mobility of the spine;
- change in gait, limping due to severe back or leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- creaking in the back when bending or turning;
- urinary and fecal incontinence, or on the contrary, constipation and urinary retention.
The symptoms of lumbar osteochondrosis in women can be supplemented by some gynecological diseases and infertility, and in men by infertility and erectile dysfunction.
Diagnostics
The diagnosis of lumbar osteochondrosis begins with a 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.
During the first consultation, the doctor does the following:
- Survey.The specialist clarifies the complaints, the time of their occurrence and the existence of a connection with provoking factors: physical activity, prolonged static posture, sudden movement, hypothermia. Also study medical records – medical reports and previous test results.
- Control. The doctor examines the skin and spine for visible injuries, damage, and deformities. Assesses gait and limb symmetry.
- Touch. Palpation of the spine reveals the presence of pain, compactions or deformities.
- Neurological examination. A consultation with a neurologist necessarily includes an assessment of the muscle strength of the limbs, their sensitivity, and the symmetry of the tendon reflexes.
After that, the patient is referred for a more detailed diagnostic examination. Laboratory tests are prescribed to assess the condition of the body:
- general and biochemical blood test, including assessment of inflammatory indicators - ESR and C-reactive protein;
- general urinalysis.
Intervertebral osteochondrosis of the lumbar region is confirmed by instrumental diagnostic methods:
- X-ray in two views. X-rays help to assess the state of the bones, identify spinal developmental disorders, detect osteophytes and pathological changes in the joints.
- CT. The layer-by-layer CT image enables a more detailed examination of the spinal column. Shows vertebrae, bone growth and other important defects. A CT scan with intravenous contrast shows the state of the blood vessels and the blood circulation of the tissues.
- MRI. It is the preferred diagnostic method because it allows obtaining a large amount of accurate information quickly and without radiation. The MRI image shows the condition of cartilage, ligaments, intervertebral discs, spinal nerve roots, spinal cord and other soft tissues.
Which doctor should I see?
Osteochondrosis is diagnosed and treated by doctors of several specialties: neurologist, vertebrologist, orthopedic traumatologist. Physiotherapists, massage therapists, acupuncturists and physical therapists are involved in the therapeutic procedures. Doctors from all these specialties work in the clinics. Qualified specialists conduct a comprehensive examination and prescribe an effective treatment 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 the visit to the doctor, and at the first signs of the disease, sign up for a consultation at the clinic.
Treatment
Only a qualified doctor can tell you what to do with lumbar osteochondrosis in men and women. Self-medication is strictly contraindicated - it can worsen the course of the disease. The doctor selects the treatment tactics strictly individually, taking into account the characteristics of each patient:
- circle,
- stage of osteochondrosis,
- current state of health,
- the presence of accompanying diseases,
- pregnancy and lactation period.
Treatment methods for osteochondrosis of the lumbar spine:
- Drug therapy.
The type of medicine, dosage, frequency and duration of administration are selected by the doctor. Depending on the clinical case, the following are prescribed:
Nonsteroidal anti-inflammatory drugs. They have anti-inflammatory and pain-relieving effects. They are prescribed taking into account the severity of pain and concomitant pathologies, especially from the gastrointestinal tract and cardiovascular system.Muscle relaxants. Eliminate back muscle tension and reduce pain.Glucocorticosteroids. It is sometimes used for severe pain and inflammation.
In case of severe pain, it is possible to prescribe drug blockades. During the procedure, pain relievers and anti-inflammatory drugs are injected directly into the source of the pain – the area next to the pinched nerve. This makes it possible to quickly relieve pain, improve the mobility of the joints of the spine and the general well-being of the patient.
- Physiotherapy.
Physiotherapy procedures improve well-being, enhance the effect of prescribed drugs and accelerate tissue regeneration. In case of osteochondrosis, the following are recommended:
- shock wave therapy,
- magnetotherapy,
- laser therapy.
In order to achieve the maximum therapeutic result, it is necessary to undergo a physiotherapy treatment consisting of several procedures. The duration and frequency of physical therapy is determined individually by the doctor.
- Massage therapy.
Massage is recommended outside the period of exacerbation. It is performed by a qualified massage therapist, who chooses the tactics of influencing the body based on the medical history. You may feel better after the first treatment, 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 the massage, endorphins are released - the hormone of joy and happiness.
- Acupuncture.
The essence of acupuncture is that the doctor inserts special sterile needles into certain points of the body. They act on the active points of the projection of the nerve endings, which lead to the source of inflammation and pain. The method helps relieve pain, relax the muscles and improve the mobility of the spine.
- Therapeutic physical education (physiotherapy).
Exercise therapy is recommended during the period of remission, that is, when there is no acute pain. The purpose of the exercises is to stretch and relax the muscles of the spinal column, strengthen them and increase the mobility of the spinal joints. Therapeutic gymnastics increases blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and appropriate physical therapy, even at home, prevents the aggravation of the disease and the development of pain attacks. And even during periods of acute pain, bed rest is contraindicated, you have to move.
Consequences
The most common consequences of lumbar osteochondrosis are caused by a developed hernia that compresses the spinal nerve roots. As a result, the following neurological symptoms appear:
- paresis or paralysis of the lower limbs, most often the legs;
- numbness, crawling sensation in the lower limbs;
- disruption of the urogenital system and intestines.
A large hernia can compress the spinal cord, which is called discogenic myelopathy. In such cases, permanent neurological symptoms develop, which sometimes lead to disability. Among the complications of osteochondrosis, it is also worth highlighting spondylosis - this is the stiffness of the joints between the vertebral arches. The disease leads to a sharp limitation of the movement of the spine.
Another unpleasant complication is chronic pain syndrome, which lasts more than 12 weeks and disturbs the patient's psycho-emotional state.
Prevention
The following will help prevent the development and progression of lumbar osteochondrosis:
- regular physical activity, gymnastics;
- weight control;
- hourly warm-up for sedentary work and prolonged standing;
- proper nutrition;
- visiting the swimming pool;
- yoga and pilates classes;
- cessation of smoking and alcohol consumption;
- avoiding heavy physical activity, especially heavy lifting;
- minimizing stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. Prescribing therapy in the early stages of the disease has a favorable prognosis for recovery. Early treatment stops degenerative processes and makes the patient's life painless and comfortable.