Osteochondrosis of the spine 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 the elderly and the elderly are susceptible to the disease. But in recent years, this diagnosis is increasingly being given to young people and even children. If osteochondrosis is not treated, severe complications can develop.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used, which help to get rid of pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral and several 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 when performing even simple daily 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 spine. This fact, together with the greatest load, makes it a favorite "target" of osteochondrosis.
Initially, the pathology affects the intervertebral discs, which lose their elasticity, become "dry" and decrease in height. Their shock-absorbing function is impaired, which causes the vertebrae to move closer to each other. The inner part of the intervertebral disc, called the nucleus pulposus, because of its softness, begins to protrude, pushing aside the fibrous ring located around it. This is how protrusions and hernias are formed. They can compress the longitudinal ligaments of the spine and spinal nerve roots, causing pain.
reasons
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, it affects people with a lack of physical activity and sedentary work. A passive lifestyle weakens the muscle corset 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 its rapid wear and tear.
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, proteins and minerals;
- burdened heredity;
- excessive physical activity;
- back injuries;
- posture disorders;
- inflammatory diseases of the joints: arthritis, arthrosis;
- congenital anomalies of the spine;
- flat feet;
- pregnancy, especially multiple pregnancy.
Symptoms
The insidiousness of osteochondrosis is that it can be asymptomatic for many years. Initially, it is a slight pain and discomfort in the lower back, which passes by itself after a short rest. Usually, 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 painkillers is needed.
Pain in the lower back with osteochondrosis is the main symptom of the pathology. Its nature, strength and location can vary greatly - it depends on what exactly is causing 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 disappear in a lying position. Often, sharp 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 limbs of varying severity, a feeling of crawling "goose feet" on the legs;
- limited mobility of the spine;
- change in gait, limping 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 retention of urine.
The symptoms of lumbar osteochondrosis in women can be supplemented by some gynecological diseases and infertility, and in men - infertility and erectile dysfunction.
Diagnosis
The diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. In addition, laboratory and instrumental research methods are performed to assess the condition of the spine and the body as a whole.
During the initial consultation, the doctor conducts:
- Research.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. Research and medical documentation - doctor's reports and results of previous studies.
- inspection. The doctor examines the skin and spine for visible injuries, damage and deformities. It assesses gait and limb symmetry.
- palpation. Palpation of the spine reveals pain, the presence of seals or deformations.
- Neurological examination. A consultation with a neurologist necessarily includes an assessment of the muscle strength of the limbs, the sensitivity in them, as well as the symmetry of the tendon reflexes.
The patient is then 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 urinalysis.
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, to identify abnormalities in the development of the spine, to detect formed osteophytes and pathological changes in the joints.
- CT. The slice CT image allows for a more detailed examination of the spine. It visualizes vertebrae, bone growths and other important defects. CT with intravenous contrast shows the state of the blood vessels and blood circulation in the tissues.
- MRI. The preferred diagnostic method, as it allows you to quickly and without radiation to obtain a large amount of accurate information. The MRI image visualizes the condition of the cartilages, 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 from several specialties: neurologist, vertebrologist, orthopedic traumatologist. A kinesitherapist, massage therapist, acupuncturist and physical therapy specialist are involved in the therapeutic procedures. Doctors from 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 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 neglected, severe and often irreversible health consequences can occur. Therefore, do not postpone your visit to the doctor and make an appointment 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 say. Self-medication is strictly contraindicated - it can worsen the course of the disease. The doctor chooses the tactics of treatment strictly individually, taking into account the characteristics of each patient:
- age,
- stage of osteochondrosis,
- current health,
- the presence of concomitant diseases,
- pregnancy and breastfeeding period.
Methods of treatment of osteochondrosis of the lumbar spine:
- Drug therapy.
The type of medicine, its dosage, frequency and duration of administration are chosen by the doctor. Depending on the clinical case, the following are prescribed:
Nonsteroidal anti-inflammatory drugs. They have an anti-inflammatory and analgesic effect. They are prescribed taking into account the severity of pain and accompanying 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. The procedure involves injecting pain-relieving and anti-inflammatory drugs directly into the source of pain - at a point located next to the pinched nerve. This allows you to quickly relieve pain, improve the mobility of the spinal joints and the general well-being of the patient.
- Physiotherapy.
Physiotherapy procedures improve well-being, enhance the effect of prescribed drugs and accelerate tissue regeneration. The following is recommended for osteochondrosis:
- shock wave therapy,
- magnetic therapy,
- laser therapy.
To achieve maximum therapeutic results, it is necessary to undergo a course of physiotherapy treatment consisting of several procedures. The doctor determines the duration and frequency of physiotherapy individually.
- Massage therapy.
Massage is indicated outside the period of exacerbation. It is performed by a qualified massage therapist who chooses the tactics to affect the body, taking into account the medical history. You may feel better after the first session, but several treatments 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 of the body. They act on active points in the projection of nerve endings leading to the source of inflammation and pain. The method helps to relieve pain, relax muscles and improve the mobility of the spine.
- Therapeutic physical education (physical therapy).
Exercise therapy is indicated in the period of remission, i. e. when there is no acute pain. The exercises are aimed at stretching and relaxing the muscles of the spine, strengthening them and increasing the mobility of the spinal joints. Therapeutic gymnastics strengthens blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and correct physical therapy, even at home, prevents the aggravation of the disease and the occurrence 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 presses on the roots of the spinal nerves. 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;
- violation of the genitourinary system and intestines.
A large hernia can compress the spinal cord, which is called discogenic myelopathy. In this case, permanent 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 spinal arches. The disease leads to a sharp restriction of movements in the spine.
Another unpleasant complication is the chronic pain syndrome, which lasts more than 12 weeks and disturbs the psycho-emotional state of the patient.
Prevention
The following will help prevent the development and progression of lumbar osteochondrosis:
- regular physical activity, gymnastics;
- body weight control;
- warming up every hour during sedentary work and a long time in a stationary position;
- proper nutrition;
- visiting the pool;
- yoga and pilates classes;
- giving up smoking and alcohol abuse;
- avoiding heavy physical activity, especially lifting weights;
- minimizing stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. Prescribing therapy in the initial stages of the disease has a favorable prognosis for recovery. Early treatment stops the degenerative processes and makes the patient's life painless and comfortable.