What is osteochondrosis of the lumbar spine?

Osteochondrosis of the lumbar region is a pathology of the musculoskeletal system, accompanied by degenerative-dystrophic changes in bone tissue and impaired functioning of the lower five vertebrae (from 20 to 24). The disease causes discomfort to the patient and is characterized by specific symptoms: pain, stiffness of movement. Osteochondrosis of the lower back occurs in waves, with periods of exacerbations and remissions. According to statistics, this form is one of the most common. A pathology that is not attended to often causes irreversible changes and a significant deterioration in quality of life. However, with a competent integrated approach, osteochondrosis can be successfully treated.

Main causes of pathology.

There is no exact data on why degenerative-dystrophic changes in the spine are triggered. It is assumed that the initiating mechanism for the development of pathology is premature age-related changes in the joints. They can be genetically determined, transmitted by inheritance, but most often they initially manifest themselves under the influence of unfavorable factors.

The main one is considered to be inadequate distribution of the load on the column. Osteochondrosis of the lumbosacral spine can develop with:

• wear high-heeled shoes;
• carry a bag or backpack on one shoulder without alternating;
• sleeping or resting for a long time in an uncomfortable position;
• sedentary work;
• lifting weights.

Among those at risk of developing osteochondrosis are older people, who are characterized by natural destructive changes in cartilage and bone tissue, professional athletes who train daily and intensively, pregnant women, whose center of gravity changes as they age. the fetus grows and the load on the lower back increases significantly, office workers are forced to spend a lot of time sitting.

In addition to external risk factors, doctors also name a group of internal risk factors. These include:

• previous injuries to the musculoskeletal system;
• curvature of the spine;
• flat feet;
• congenital dislocation or subluxation of the hip joint;
• autoimmune disorders;
• inflammation of joint tissues;
• pathologies of the circulatory system;
• endocrine diseases;
• obesity.

Osteochondrosis of the lower back can also be provoked by prolonged intoxication and dehydration, bad habits, calcium deficiency and any mechanical effects on the lower back: bruises, bumps, falls.

Osteochondrosis of the lumbar spine: symptoms

Pathology affects not only the bone tissue itself, but also the entire segment of the spine: vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Osteochondrosis of the lumbar spine develops, the symptoms of which become evident with significant damage, gradually and slowly. In the early stages it is a moderate discomfort during exercise, in the later stages it is an unbearable sharp pain. Clinical signs are pronounced in the acute stage. During the period of remission, they disappear, and in the early stages this happens even without treatment.

Osteochondrosis of the lumbar spine - symptoms:

• pain in the affected area of the spine;
• radiation of pain up to the shoulder blade area or down to the pelvis and hip joints;
• persistent feeling of tension in the lower back;
• difficulty bending and turning the body;
• flexible;
• limp;
• muscle weakness or, conversely, increased tone;
• tingling sensation.

Not all of the symptoms described are always present at the same time. Pain may be associated with limited mobility, but not with muscle weakness or numbness. Any of the signs mentioned above will be reason to consult a doctor.

Stages of the disease

The intensity of the symptoms accompanying osteochondrosis of the lumbosacral spine directly depends on the degree of development of the pathology. There are four in total.

1. First stage. The first structural and functional changes begin. The intervertebral discs dry out and can crack. Symptoms at this stage are minor. Many patients confuse them with fatigue after a day of work, wearing uncomfortable shoes, or exercising. The key signs of early osteochondrosis are mild discomfort in the lower back, which increases when bending and twisting. There may be mild pain, which will go away on its own after rest.
2. Second stage. The height of the intervertebral discs decreases, the bone structures become closer. This causes a new set of symptoms: stiffness when moving and pain. The pain becomes prolonged and intense and may radiate to the pelvis and legs.
3. Third stage. At this stage, the vertebrae become deformed. Protrusions form: the intervertebral discs protrude into the spinal canal area, but the fibrous rings remain intact. The main symptoms are intense pain, annoying even at rest, decreased sensitivity, crackling and clicking when moving, tingling and numbness in the lower back.
4. Fourth stage. Pathological changes continue to progress. The functions of the vertebrae are lost. Hernias form. Osteophytes (bone growths) form. Blood vessels and nerve fibers can be pinched. Against the background of impaired blood circulation, the functioning of the pelvic organs is disturbed. In men, the risk of erectile dysfunction increases; In women, alterations in the menstrual cycle are observed. Advanced osteochondrosis is manifested by acute lumbago in the lumbar area, limping, reduced mobility up to complete immobility and increased temperature.

If you are worried about lumbar osteochondrosis, your treatment will directly depend on the stage at which the disease is diagnosed. In the early stages, the doctor has many more recovery methods and techniques in his arsenal. Detection of degenerative-dystrophic changes in the initial stages makes it possible to treat the pathology conservatively, without resorting to surgical intervention.

Forms of pathology

The division into forms is based on the characteristics of the pain syndrome that always accompanies osteochondrosis of the lumbar sacral spine. There are three in total:

1. Lumbago. It is a sharp stabbing pain that makes movement impossible. Causes of pain can be pinched nerves or muscle spasms.
2. Lumbodynia. This is a long-term painful pain. It is characteristic of the stage of formation of protrusions and hernias. Additionally, discomfort may be associated with ligament sprains.
3. Sciatica. It is an intense pain that radiates to the pelvic area. The patient complains of pain when walking, sitting, or changing body position.

Two more forms of pathology are distinguished depending on the accompanying symptoms. The patient can be diagnosed:

1. Radiculopathy. Accompanied by compression of nerve endings due to deformation of the vertebrae. With this form of the disease, sensitivity decreases and the affected area becomes numb. Sensations of pain and tingling are expressed. Possible decrease in muscle tone, impaired reflexes, tingling in the legs.
2. Discogenic lumbar osteochondrosis. This is a serious condition in which the patient has limited movements. Your lower back and extremities are numb. Other symptoms are general weakness, fever, involuntary urination and, if the illness is prolonged, weight loss.

Danger of spinal disease

If left untreated, osteochondrosis is fraught not only with unbearable pain and stiffness of movement, but also with a number of pathologies that can develop against its background. The most common complications:

• intervertebral hernia;
• inflammation of the sciatic nerve;
• radiculitis;
• paresis.

To prevent concomitant pathologies, it is necessary to start treating osteochondrosis immediately from the moment of its detection. With a competent therapeutic approach, it is possible to stop or significantly slow down the destruction of bone and cartilage tissue.

Methods for diagnosing pathology.

Osteochondrosis of the lumbar sacral spine must be differentiated from other pathologies of the musculoskeletal system, which can present with similar symptoms. The primary stage is a consultation with a neurologist, orthopedist or surgeon. The doctor clarifies the complaints, collects a history, conducts a physical examination, paying attention to the features of the patient's posture and posture, the nature of his work activity, bad habits and concomitant diseases.

For the most accurate diagnosis, instrumental techniques are used:

• MRI;
• radiography;
• myelography with contrast agent;
• Multi-slice CT.

Each of the diagnostic procedures allows the doctor to evaluate the condition of the lumbar and sacral spine at the current moment. The images clearly show structural changes in the vertebrae, indicating the stage of osteochondrosis. Based on the data obtained, the specialist makes a decision on the tactics for further treatment of the patient.

Laboratory diagnosis is not of key importance, however, studies may be recommended if indicated. In particular, if lumbar osteochondrosis is diagnosed, treatment may be prescribed based on the results of blood tests. They are necessary to clarify the intensity of inflammatory processes in the muscle fibers adjacent to the spine.

Lumbar osteochondrosis: treatment

The fight against pathology is carried out under the supervision of a neurologist and begins after a comprehensive diagnosis, when the degree and extent of tissue damage is determined. Modern medicine offers a number of effective conservative methods. If its use does not produce the expected result, doctors resort to surgery.

Lumbar osteochondrosis: treatment with physiotherapy methods.

All physiotherapy techniques are good because they comprehensively affect the sacral and lumbar spine. This approach allows you to cope with pain, reduce inflammation and restore normal blood circulation.

When osteochondrosis of the lumbar spine progresses, treatment must be comprehensive. Patients with complaints are prescribed:

• electrophoresis - exposure of the problem area to constant electrical impulses with the possibility of using medications for external use;
• diadynamic therapy: a variant of electrotherapy that uses pulsed currents;
• magnetotherapy – treatment with alternating or static magnetic fields;
• ultrasound therapy - the influence of high-frequency sound waves;
• shock wave therapy - exposure to low-frequency acoustic impulses;

It is important to consider two nuances. First of all, the effect of physiotherapy treatment is noticeable only after a course of procedures, the duration of which is selected individually for each patient. The second is that physiotherapy as an independent method works for osteochondrosis of the initial degree. For large lesions it is recommended as an auxiliary technique in addition to medical and surgical treatment.

Lumbar osteochondrosis: treatment with medications.

Pharmacotherapy for injuries of the lumbar and sacral spine is aimed at relieving acute pain and suppressing inflammatory processes. The method is relevant in the acute stage, when symptoms interfere with a full life.

How to treat lumbar osteochondrosis with medications is always decided individually. A neurologist can prescribe medications from different pharmacological groups. Essential:

• NSAIDs (systemic and local) to suppress inflammation in the vertebrae and adjacent tissues;
• muscle relaxants to relieve muscle spasms;
• angioprotectors to improve blood circulation;
• chondroprotectors to protect the cartilaginous tissue of the intervertebral discs from destruction;
• B vitamins to improve nerve conduction;
• analgesics for sharp stabbing pains that limit mobility.

Exercise therapy as a method of treating pathology of the sacral and lumbar regions.

Intense training for osteochondrosis is strictly prohibited, but physical activity cannot be completely abandoned. On the contrary, exercises of moderate strength and duration help restore blood circulation and reduce pain.

How to treat osteochondrosis of the lumbar spine with exercise therapy:

1. Exercise with an instructor. The trainer will show you which exercises are allowed in a particular situation and make sure they are performed correctly. Even the smallest glitches in technology can significantly reduce the effectiveness of training or even cause damage.
2. Prepare carefully for the lesson. Before exercise, it is recommended to warm up the muscles; It can gently massage the lumbar area and sacrum.  
3. Strictly dose the load. The lower back is a vulnerable area. To avoid excessive efforts, it is necessary to control the duration of classes. Its optimal duration is no more than 20 minutes.
4. Gradually increase exercise intensity. For inexperienced beginners, simple exercises and short programs are suitable. For those who have been doing physical therapy for some time, you can move on to more complex options.
5. Remember to be regular. A one-time workout will not bring visible improvements. Pain in the lumbar and sacral spine decreases if the patient performs exercise therapy regularly, optimally twice a week.
6. Consider contraindications. Physiotherapy has been shown to be a safe method to help with osteochondrosis, but there are limitations. You should stop exercising if you feel unwell: fever, weakness or increased temperature.

Lumbar osteochondrosis, the treatment of which should take into account the duration of the disease, will not bother you if all the rules are strictly followed.

1. In the acute period. Only smooth and slow movements are allowed. If the pain increases during exercise, it is necessary to stop and give the joints a rest.
2. In the subacute period. The pain syndrome subsides, mobility is restored, so the intensity of training can be slightly increased and its duration increased. But to avoid deterioration, it is necessary to carefully monitor your well-being.
3. In remission. We allow a full range of exercises for pathologies of the lumbar spine, but it is important to remember that excessive exertion leads to a new exacerbation of the disease.

If lumbar osteochondrosis of mild or moderate severity is diagnosed, treatment with physical education can also be carried out at home. Once the exercise technique has been perfected under the supervision of an instructor, it is not prohibited to repeat the exercises at home. To train you will need a gym mat, a roller and a ball.

Modern physiotherapy and rehabilitation rooms are equipped not only with traditional accessories, but also with special medical simulators. They help you recover from illness gently and safely, and also make activities more fun and interactive. For example, the neuromuscular rehabilitation system turns rehabilitation into an exciting competition with oneself. The patient stands on a moving platform and performs the exercises presented on the screen. Another important advantage of the simulator is the ability to track even the slightest progress in the patient's condition. The system evaluates the result of each exercise performed and the doctor can see the progress from one workout to another. Knowing one's own success also motivates patients to try harder and not give up.

manual therapy

Good results can be achieved if exercise therapy and medication for lumbar pathology are complemented with manual therapy. The method allows:

• eliminate hypertonicity of muscle fibers;
• relieve pain;
• restore blood supply to the lumbar and sacral areas;
• improve the course of metabolic processes.

Manual therapy is an effective way to properly redistribute the load on the spine and protect yourself from future destructive changes. The good thing about this method is that it not only relieves pain, but also prevents neurological disorders that often develop against the background of lumbar osteochondrosis.  

Currently, chiropractors combine massage and physical therapy methods, such as tecartherapy. Electromagnetic waves penetrate deep into bone tissue and allow you to relieve pain attacks and quickly restore mobility.  

Surgical methods

Osteochondrosis of the lumbar spine, the treatment of which with medications, physiotherapy and physiotherapy is not always effective, significantly complicates the patient's life. In some cases, only surgical intervention is applicable to eliminate pain and restore back mobility. Modern technological methods and equipment make it possible to perform minimally invasive operations with a shorter rehabilitation period.

For osteochondrosis, the following intervention methods are relevant:

• endoscopic excision of an intervertebral hernia, using microsurgical instruments and a built-in camera;
• transfacet excision of intervertebral hernia, using neurosurgical tube dilators;
• laminectomy – surgical removal of pathologically modified bone processes;
• microdiscectomy – removal of the hernia protrusion.

Direct indications for surgical intervention are recurrent hernias, spinal stenosis, when the spinal canal narrows, and degenerative spondylolisthesis, a pathology in which the vertebrae shift relative to each other. In all other cases, if osteochondrosis of the lumbar spine is confirmed, doctors try to carry out treatment using conservative methods.

Disease prevention

The symptoms of osteochondrosis cause discomfort, and treatment of the pathology can take a long time. It is much more effective to protect the vulnerable lumbar region from excessive strain in advance. For preventive purposes it is recommended:

1. Properly organize your workplace during office work. The back of the chair should support the lumbar area and the table should be appropriate for the height.
2. Avoid uncomfortable shoes. The optimal heel height for women is up to 5 cm. It is also advisable to exclude flat soles, as they contribute to foot deformation and flat feet, one of the factors.
3. risk of osteochondrosis.
4. Exercise. Lifting heavy objects should be avoided. Swimming, walking and cardiovascular exercise are useful if there are no contraindications.
5. Eat a balanced diet. The diet should contain foods that are sources of calcium, phosphorus and vitamin B. These are fish, dairy products, green leafy vegetables and cereals. These substances are necessary to strengthen all elements of the joints and support the nervous system.
6. Make sure you get enough sleep. It is better to sleep on an orthopedic mattress of medium hardness. It will provide an anatomically correct posture in which the body rests from daily stress.
7. Control body weight. Obesity is one of the provoking factors. If the weight is normal, the load on the spine will be properly distributed and the risk of circulatory disorders will be minimized.

The prognosis for patients with osteochondrosis directly depends on the degree of damage to the vertebrae. That is why timely diagnosis is extremely important. If you are worried about low back pain and imaging reveals destructive processes in the initial stages, you should start treatment. In the early stages, medications and physical therapy are effective. In later cases, it is rarely possible to do without surgery. Exercise therapy can be used as an additional measure of assistance in any form and at any stage.