Spinal osteochondrosis is a chronic degenerative disease that affects the vertebrae, intervertebral discs, facet joints, ligaments and other tissues that form the musculoskeletal system. Many people believe that only adults and older people 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, severe complications may develop.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used to help get rid of pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spinal column: 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 spinal column. This fact, together with the heaviest load, makes it a favorite "target" of osteochondrosis.
Initially, the pathology concerns the intervertebral discs, which lose their elasticity, become "dry" and decrease in height. Their shock-absorbing function is disrupted, causing the vertebrae to move closer to each other. The inner part of the intervertebral disc, called the nucleus pulposus, due to its softness, begins to bulge, pushing aside the fibrous ring located around it. This is how protrusions and hernias form. They can compress the longitudinal ligaments of the spine and spinal nerve roots, 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 muscle corset and reduces the mobility of the spinal column. Because of this, the muscles lose the ability to hold the spine in the correct physiological position, which leads to its rapid wear.
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, protein and minerals;
- burdened heredity;
- excessive physical activity;
- back injuries;
- posture disorders;
- inflammatory diseases in the joints: arthritis, arthrosis;
- congenital anomalies of the spinal column;
- flat feet;
- pregnancy, especially multiple pregnancy.
Symptoms
The insidiousness of osteochondrosis is that it can be asymptomatic for many years. At first it is a slight pain and discomfort in the lower back, which goes away on its own after a short rest. Typically, patients do not pay attention to these signs and do not consult a doctor. But gradually the intensity of the unpleasant sensations increases, and to relieve them, more rest or taking a painkiller is required.
Lower back pain with osteochondrosis is the main symptom of the pathology. Its nature, severity and location can vary greatly - it depends on what exactly causes the pain. Most often, patients complain of aching pain, which intensifies during physical activity, prolonged standing in a stationary position, sneezing and coughing. Sometimes the pain spreads to the leg, sacrum and buttocks. Unpleasant sensations go away in a supine position. Often acute and sharp pain is described by patients as a "shot in the back. "
Other common complaints:
- stiffness and tension in the back muscles;
- impaired sensitivity in the lower extremities of varying severity, a feeling of crawling "goosebumps" on the legs;
- limited mobility of the spinal column;
- change in gait, limp due to severe back pain or leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- crunching in the back when bending or turning;
- urinary and fecal incontinence or, conversely, constipation and urinary retention.
Symptoms of lumbar osteochondrosis in women can be complemented by some gynecological diseases and infertility, and in men - infertility and erectile dysfunction.
Diagnostics
Diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. Additionally, laboratory and instrumental examination methods are carried out to assess the condition of the spinal column and the body as a whole.
At the initial consultation, the doctor conducts:
- Survey.The specialist clarifies the complaints, the time of their occurrence and the presence of a connection with provoking factors: physical activity, prolonged static posture, sudden movement, hypothermia. He also studies medical documentation - doctor's reports and the results of previous examinations.
- Inspection. The doctor examines the skin and spine for visible injuries, damage and deformities. He evaluates gait and limb symmetry.
- Palpation. During palpation of the spine, pain, the presence of compactions or deformities are revealed.
- Neurological examination. A consultation with a neurologist necessarily includes an assessment of the muscle strength of the limbs, sensitivity in them, as well as the symmetry of tendon reflexes.
After this, the patient is referred for a more detailed diagnostic examination. To assess the condition of the body, laboratory tests are prescribed:
- general and biochemical blood test, 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:
- X-ray 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.
- CT. A layer-by-layer CT image makes it possible to study the spinal column in more detail. It visualizes vertebrae, bone growths and other important defects. CT scan with intravenous contrast shows the condition of blood vessels and blood circulation in tissues.
- MRI. The preferred diagnostic method, as it allows you to obtain a large amount of accurate information quickly and without radiation. An MRI image visualizes the condition of 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 several specialties: neurologist, vertebrologist, orthopedic traumatologist. For therapeutic procedures, a physiotherapist, massage therapist, acupuncturist and physical therapy specialist are involved. Doctors of all these specialties work in 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, severe 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 type of drug, its dosage, frequency and duration of administration are selected by the doctor. 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 from the gastrointestinal tract and cardiovascular system.
- Muscle relaxants.Eliminate back muscle strain and reduce pain.
- Glucocorticosteroids.Sometimes used for severe pain and inflammation.
In cases of severe pain, it is possible to prescribe drug blockades. The procedure involves injecting painkillers and anti-inflammatory drugs directly into the source of pain - at a point located next to the compressed nerve. This allows you to quickly relieve pain, improve the mobility of the spinal joints 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 are recommended:
- shock wave therapy,
- magnetotherapy,
- laser therapy.
To achieve maximum therapeutic results, it is necessary to undergo a course of physiotherapeutic treatment consisting of several procedures. The doctor determines the duration and frequency of physical therapy individually.
- Massotherapy.
Massage is indicated outside the period of exacerbation. It is performed by a qualified massage therapist 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 for lasting results. One of the main advantages of therapeutic massage is its additional impact on the psycho-emotional state. During a massage, endorphins are released - hormones of pleasure and joy.
- 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 leading to the source of inflammation and pain. The method helps relieve pain, relax muscles and improve spinal mobility.
- Therapeutic physical education (physical therapy).
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 spinal column, strengthening them and increasing the mobility of the spinal joints. Therapeutic gymnastics increases blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and proper physical therapy, even at home, prevents exacerbation of the disease and the onset of an attack of pain. 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 formed hernia that compresses the spinal nerve roots. As a result, the following neurological symptoms occur:
- paresis or paralysis of the lower extremities, most often the feet;
- numbness, crawling sensation in the lower extremities;
- disruption of the genitourinary system and intestines.
A large hernia can compress the spinal cord, which is called discogenic myelopathy. In this case, persistent neurological symptoms develop, which sometimes lead to disability. Also among the complications of osteochondrosis, it is worth highlighting spondylosis - this is stiffness of the joints between the vertebral arches. The disease leads to a sharp limitation of movements in the spine.
Another unpleasant complication is chronic pain syndrome, which lasts over 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;
- visiting the swimming pool;
- yoga and pilates classes;
- quitting smoking and alcohol abuse;
- avoidance of heavy physical activity, especially heavy lifting;
- minimizing stress.
Timely visit to the clinic can prevent dangerous complications of osteochondrosis. Prescribing therapy at the initial stages of the disease has a favorable prognosis for recovery. Early treatment stops degenerative processes and makes the patient’s life painless and comfortable.