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 the elderly are susceptible to the disease. But in recent years, this diagnosis is increasingly made to young people and even children. If osteochondrosis is not treated, serious complications can occur.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used that help eliminate 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 greatest load when performing even simple everyday activities: lifting heavy objects, walking, running, sitting. The lumbar vertebrae are the largest, therefore 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, combined with the heavier load, makes it a preferred "target" for osteochondrosis.
Initially, the pathology concerns the intervertebral discs, which lose their elasticity, become "dry" and decrease in height. Its 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 swell, pushing away the fibrous ring located around it. This is how bumps 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. Firstly, it affects people with a lack of physical activity and sedentary work. A passive lifestyle weakens the muscular corset and reduces spinal mobility. As a result, the muscles lose their ability to maintain the spine in the correct physiological position, which leads to rapid wear.
The main risk factors for developing osteochondrosis include:
- frequent lifting of heavy objects;
- overweight, obesity;
- endocrine diseases, hormonal imbalance;
- poor nutrition, insufficient intake of vitamins, proteins and minerals;
- burdened heredity;
- excessive physical activity;
- back injuries;
- postural disorders;
- inflammatory joint diseases: arthritis, arthrosis;
- congenital anomalies of the spine;
- flat foot;
- pregnancy, especially multiple pregnancy.
Symptoms
The insidiousness of osteochondrosis is that it can be asymptomatic for many years. At first it is mild 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 alleviate them, more rest or taking a painkiller is necessary.
Lower back pain in 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 severe pain, which intensifies during physical activity, prolonged stay in a stationary position, sneezing and coughing. Sometimes the pain spreads to the leg, sacrum and buttocks. Unpleasant sensations disappear in the supine position. Often, the sharp, stabbing pain is described by patients as feeling like 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 "goosebumps" in the legs;
- limited spinal mobility;
- change in gait, lameness due to severe back or leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- crushing 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.
Diagnosis
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 spine and the body as a whole.
At the initial consultation, the doctor performs:
- Survey.The specialist clarifies the complaints, the moment of their occurrence 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 previous examination results.
- 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 impactions or deformities are revealed.
- Neurological examination. Consultation with a neurologist necessarily includes an assessment of the muscle strength of the limbs, their sensitivity, 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.
- TC. A layer-by-layer CT image allows you to study the spine in more detail. Visualizes vertebrae, bone growths and other important defects. Computed tomography 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 are carried out by doctors of different specialties: neurologist, vertebrologist, orthopedic traumatologist. For therapeutic procedures, a physiotherapist, massage therapist, acupuncturist and physiotherapist are involved. Doctors from all of these specialties work in clinics. Qualified specialists carry out a comprehensive examination and prescribe effective treatment individually for each patient.
It is important not to self-medicate, but to seek professional help immediately. 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 a visit to the doctor and make an appointment 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 - it can aggravate the course of the disease. The doctor chooses treatment tactics strictly individually, taking into account the characteristics of each patient:
- age,
- osteochondrosis stage,
- current health,
- the presence of concomitant diseases,
- period of pregnancy and lactation.
Treatment methods for osteochondrosis of the lumbar spine:
- Drug therapy.
The type of medication, its dosage, frequency and duration of administration are selected by the doctor. Depending on the clinical case, the following is prescribed:
- Nonsteroidal anti-inflammatory drugs.They have anti-inflammatory and analgesic effects. They are prescribed taking into account the intensity of pain and concomitant pathologies, mainly of the gastrointestinal tract and cardiovascular system.
- Muscle relaxants.Eliminate back muscle tension and reduce pain.
- Glucocorticosteroids.Sometimes used for severe pain and inflammation.
In cases of severe pain, it is possible to prescribe medication blocks. The procedure involves injecting painkillers and anti-inflammatories directly into the source of the pain - at a point located close to the compressed nerve. This allows you to quickly relieve pain, improve the mobility of the spinal joints and the patient's general well-being.
- 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 obtain maximum therapeutic results, it is necessary to carry out a physiotherapeutic treatment consisting of several procedures. The doctor determines the duration and frequency of physiotherapy individually.
- Massage therapy.
Massage is indicated outside the exacerbation period. It is carried out 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 it takes several procedures to get 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 that lead to the origin of inflammation and pain. The method helps to 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 aim to stretch and relax the spinal muscles, strengthening them and increasing the mobility of the spinal joints. Therapeutic gymnastics increases blood circulation and stimulates metabolism - which improves tissue nutrition.
Regular and adequate physiotherapy, even at home, prevents the disease from worsening and the appearance of pain attacks. And even in periods of acute pain, bed rest is contraindicated, you need to move around.
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 - stiffness of the joints between the vertebral arches. The disease leads to a marked 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;
- warming up every hour when working sedentary and staying in a stationary position for a long time;
- proper nutrition;
- visiting the pool;
- yoga and pilates classes;
- stop smoking and alcohol abuse;
- avoid intense physical activity, especially weight lifting;
- minimizing stress.
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.