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 think that only adults and older people are susceptible to the disease. But in recent years, this diagnosis has increasingly been 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 to help eliminate pain and stop the progression of the disease without surgical intervention.
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 heaviest load when performing even simple everyday activities: lifting heavy objects, walking, running, sitting. The lumbar vertebrae are the largest, so the intervertebral discs between them are also the largest. The lumbar region is, along with the cervical region, the most mobile part of the spine. This fact, together with the heaviest load, makes it a favorite "target" for osteochondrosis.
Initially, the pathology concerns the intervertebral discs, which lose their elasticity, become "dry" and decrease in height. Their shock absorption function is disrupted, causing the vertebrae to move closer together. The inner part of the intervertebral disc, called the nucleus pulposus, because of its softness, begins to swell, pushing out the annulus fibrosus 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, it affects people suffering from 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 the 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 joint diseases: arthritis, osteoarthritis;
- congenital spinal anomalies;
- flat foot;
- pregnancy, especially multiple pregnancy.
Symptoms
The insidious nature of osteochondrosis is that it can remain 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. 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, you need to rest more or take painkillers.
Lower back pain with osteochondrosis is the main symptom of the pathology. Its nature, severity and location can vary greatly - it depends on the exact cause of the pain. Most often, patients complain of aching pain, which intensifies during physical activity, prolonged stationary position, sneezing and coughing. Sometimes the pain spreads to the leg, sacrum and buttocks. Unpleasant sensations disappear in the supine position. Patients often describe sharp, sharp pain 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, feeling of creeping "goosebumps" on the legs;
- limited mobility of the spine;
- change in gait, lameness due to severe back or leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- cracking the back when bending or turning;
- urinary and fecal incontinence or, conversely, constipation and urinary retention.
Symptoms of lumbar osteochondrosis in women can be supplemented by some gynecological diseases and infertility, and in men - infertility and erectile dysfunction.
Diagnostic
Diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. Additionally, laboratory and instrumental examination methods are used to assess the condition of the spine and the body as a whole.
During the first consultation, the doctor does:
- Investigation.The specialist clarifies the complaints, the time of their appearance and the presence of a connection with provoking factors: physical activity, prolonged static posture, sudden movement, hypothermia. He also studies medical documentation - doctors' reports and results of previous examinations.
- Inspection. The doctor examines the skin and spine for visible injuries, damage, and deformities. It evaluates the gait and symmetry of the limbs.
- Palpation. When palpating the spine, pain, the presence of compaction or deformation are revealed.
- Neurological examination. A consultation with a neurologist necessarily includes an assessment of the muscular strength of the limbs, their sensitivity, as well as the symmetry of the 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 urine analysis.
Intervertebral osteochondrosis of the lumbar region is confirmed by instrumental diagnostic methods:
- Two-projection x-ray. An x-ray image allows you 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 allows you to study the spine in more detail. It visualizes vertebrae, bony growths and other important defects. Computed tomography with intravenous contrast shows the condition of blood vessels and blood circulation in the tissues.
- MRI. The preferred diagnostic method because it allows a large amount of precise information to be obtained 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 interventions, a physiotherapist, massage therapist, acupuncturist and physiotherapy 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, serious 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 - 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 state of health,
- the presence of concomitant diseases,
- period of pregnancy and breastfeeding.
Methods for treating osteochondrosis of the lumbar spine:
- Drug therapy.
The type of medication, its dosage, frequency and duration of administration are chosen by the doctor. Depending on the clinical case, the following are 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, including the gastrointestinal tract and the cardiovascular system.
- Muscle relaxers.Eliminates back muscle tension and reduces pain.
- Glucocorticoids.Sometimes used for severe pain and inflammation.
In case of severe pain, it is possible to prescribe drug blockages. The procedure involves injecting painkillers and anti-inflammatories directly into the source of the pain, at a point next to the compressed nerve. This helps 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 optimal therapeutic results, it is necessary to undergo physiotherapeutic 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 carried out by a qualified massage therapist who chooses tactics of influence on the body taking into account medical history. You may feel better after the first session, but several procedures are necessary to achieve 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 the active points of 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 (physiotherapy).
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 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 proper physiotherapy, even at home, prevents the exacerbation of the disease and the appearance of a pain attack. And even during periods of acute pain, bed rest is contraindicated, you need 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 appear:
- paresis or paralysis of the lower limbs, 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. Among the complications of osteochondrosis, it is also worth highlighting spondylosis - this is stiffness of the joints between the vertebral arches. The disease causes severe limitation of spinal movements.
Another unpleasant complication is chronic pain syndrome, which lasts more than 12 weeks and disrupts 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;
- warm up every hour when working sedentary and staying in a stationary position for a long time;
- adequate nutrition;
- visit the swimming pool;
- yoga and Pilates classes;
- stop smoking and abusing alcohol;
- avoid strenuous physical activity, especially lifting heavy objects;
- minimize stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. Prescribing treatment 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.