Osteochondrosis of the spine 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 increasingly been 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 that help eliminate pain and stop the progression of the disease without surgery.
Osteochondrosis can appear 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. Lumbar vertebrae are the largest, so the intervertebral vertebrae 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, together with the greatest load, makes it a favorite "target" of osteochondrosis.
Initially, the pathology refers to the intervertebral discs, which lose elasticity, become "dry" and decrease in height. Their cushioning function is disrupted, due to which the vertebrae move closer to each other. The inner part of the intervertebral disc, called the nucleus pulposus, due to its softness, begins to protrude, pushing aside the fibrous ring that is 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.
Causes
The exact cause of osteochondrosis is not known. But the fact that the disease is often diagnosed in representatives of certain groups indicates 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 muscular 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 are:
- 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 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 mild pain and discomfort in the lower back, which disappears 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 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, severity and location can vary greatly - it depends on what exactly is causing the pain. Most often, patients complain of aching pains, which intensify 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 the lying position. Patients often describe acute and sharp pain as "shooting in the back".
Other common complaints:
- stiffness and tension of the back muscles;
- disturbed sensitivity in the lower extremities of varying severity, a feeling of creeping "goosebumps" on the legs;
- limited mobility of the spinal column;
- change in gait, limping due to severe pain in the back or legs;
- 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.
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 testing methods are carried out to assess the condition of the spinal column and the body as a whole.
During the initial consultation, the doctor conducts:
- Survey.The specialist explains the complaints, the time of their occurrence and the presence of connections with provoking factors: physical activity, prolonged static posture, sudden movements, hypothermia. He also studies the medical documentation - the doctor's findings and the results of previous examinations.
- Inspection. The doctor examines the skin and spine for visible injuries, damage and deformities. He assesses the gait and symmetry of the limbs.
- Palpation. Palpation of the spine reveals pain, the presence of compression or deformity.
- Neurological examination. A 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 that, 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 urinalysis.
Intervertebral osteochondrosis of the lumbar region was confirmed by instrumental diagnostic methods:
- X-ray in two projections. The 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. Layer by layer CT images allow for a more detailed study of the spinal column. Visualizes vertebrae, bony growths and other important defects. CT with intravenous contrast shows the state of blood vessels and blood circulation in tissues.
- MRI. The preferred diagnostic method, because it allows you to get 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. A physiotherapist, massage therapist, acupuncturist and physical therapy specialist are involved in the therapeutic procedures. 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 the help of a specialist. 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 the visit to the doctor and sign up for a consultation at the clinic at the first signs of illness.
Treatment
Only a qualified doctor can tell 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 chooses treatment tactics strictly individually, taking into account the characteristics of each patient:
- age,
- stage of osteochondrosis,
- current health,
- the presence of accompanying diseases,
- pregnancy and lactation period.
Methods of treatment of osteochondrosis of the lumbar spine:
- Drug therapy.
The type of medicine, its dose, frequency and duration of administration are chosen by the doctor. Depending on the clinical case, it is prescribed:
Nonsteroidal anti-inflammatory drugs. They have anti-inflammatory and analgesic effects. 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 strain and reduce pain.Glucocorticosteroids. It is 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 the pain - at the site 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.
Physiotherapy procedures improve well-being, enhance the effect of prescribed drugs 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 duration and frequency of physical therapy is determined by the doctor individually.
- Masotherapy.
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 required for lasting results. One of the main advantages of therapeutic massage is its additional impact on the psycho-emotional state. During the 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, which leads 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 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 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 the worsening of the disease and the onset of pain attacks. Even during the period of acute pain, resting in bed 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;
- disorder 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 the stiffness of the joints between the arches of the vertebrae. The disease leads to a sharp restriction of movement 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;
- warming up every hour during sitting work and a long stay in a stationary position;
- proper nutrition;
- visit to the swimming pool;
- yoga and pilates classes;
- cessation of smoking and alcohol abuse;
- avoiding heavy physical activity, especially lifting heavy loads;
- 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 degenerative processes and makes the patient's life painless and comfortable.