Lumbar osteochondrosis: symptoms and treatment

Osteochondrosis of the lumbar spine is a common disease that reduces a person's quality of life and is one of the causes of disability.

The pathology is more common in people over the age of 40, is characterized by gradual progression and therefore requires adequate conservative or surgical treatment.

Development mechanism

The main mechanism for the development of osteochondrosis is a violation of the nutrition of the cartilaginous tissue of the spinal structures.

The disease includes several pathogenetic links:

• Cartilage tissue dystrophy due to malnutrition is the main trigger of the disease.
• Degeneration (damage and destruction) of the spinal cartilage (intervertebral discs, articular surfaces of the vertebral processes).
• An inflammatory reaction with tissue swelling, blood pooling and pain.
• A change in the ratio of the anatomical structures of the lumbar spine (flattening of the intervertebral discs with a decrease in their height), which leads to a decrease in the diameter of the holes between the vertebrae through which the roots of the spinal cord pass.
• Compression of the nerve fibers of the roots of the spinal cord, which leads to interruption of the passage of impulses and the subsequent development of the corresponding neurological symptoms.

Changes in cartilage components develop gradually over a long period of time.Timely initiation of preventive and therapeutic measures allows you to slow down the progression of the disease.

Reasons

Osteochondrosis of the lumbar spine is a polyetiological disease that develops due to several causes:

• Hereditary predisposition that determines the nutritional characteristics of cartilaginous tissue at a genetic level.
• Diseases of the endocrine, digestive and cardiovascular systems.
• Autoimmune inflammatory diseases affecting the joints of the spine (rheumatoid arthritis, systemic lupus erythematosus, rheumatism).
• Metabolic disorders in the human body.
• Systematic heavy physical work with increased loads on the spine, weight lifting.
• Previous injuries to the spine, especially in the lumbar region (cause of a violation of the relationship of the components of the vertebrae with subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or defects of the spine.

The realization of the negative impact of the case is most possible against the background of the following risk factors:

• Increased weight, which increases the load on the spine.
• Long-term systematic permanence of the human body in an upright position.
• Incorrect posture.
• Hypothermia, also local in the posterior area.
• Systematic exposure to stress, lack of sleep, irrational work and rest regime.

Knowledge of the causes and risk factors will allow effective preventive measures to be implemented.

Symptoms of lumbar osteochondrosis

The possible development of osteochondrosis is indicated by the appearance of the following characteristic symptoms:

• Pain in the lumbar region, which initially appears when the load on the spine increases.Then it becomes constant, has a pulling or painful character and gradually intensifies.
• Radiation of pain in the leg on the side of the crushed spinal cord root.
• Increased tone (tension) of the back muscles in the lumbar region.
• Decreased muscle strength in one or both legs.
• Periodic “excruciating” pain in the back, caused by local hypothermia and physical effort.
• Loss of skin sensitivity on one or both legs, accompanied by numbness and tingling sensation.
• “Cold feet”: the skin becomes cold to the touch due to spasm of the arterial vessels, caused by compression of the autonomic nerve fibers of the spinal roots.
• Impaired sweating: the skin of the feet becomes dry or, conversely, sweating increases.
• Peeling of the skin in the area of sensitivity disorder caused by a violation of autonomic innervation.

Osteochondrosis is a chronic disease.Clinical symptoms increase gradually over a long period of time.Periods of improvement (remission) are followed by an exacerbation of the pathology, accompanied by an increase in clinical symptoms.After exposure to a provoking factor (hypothermia, physical and emotional stress, stress), a sharp increase in attack-like pain is possible, provoked by an inflammatory reaction and swelling of soft tissues in the area of the spinal roots.

Depending on the prevailing symptoms, different clinical forms of the disease are distinguished:

• Lumbbodynia is a periodic paroxysmal pain in the lower back that develops after exposure to provoking factors.
• Lumboischalgia: Pain occurs in the lower back and radiates to the buttocks or legs.
• Radiculitis is a pathological process accompanied by compression of one or more roots, while the clinical picture is dominated by neurological symptoms, including reduced skin sensitivity and decreased muscle strength.
• Radiculoischemia: compression affects the arterial vessels and serious motor disorders develop.

Each clinical form of osteochondrosis does not develop in isolation;they are usually combined with each other.As it progresses, the person's condition worsens.Severe destruction of cartilaginous structures can lead to disability.

Diagnostics

The diagnosis of osteochondrosis of the lumbar spine is based on visualization of changes in the vertebrae, intervertebral discs and soft tissues.

For this purpose, various instrumental research methods are prescribed:

• X-ray is a technique that allows you to visualize obvious changes.It has become widespread due to its accessibility.
• Computed tomography is an X-ray method of scanning tissue layer by layer, which has high resolution and allows you to visualize minimal changes.
• Magnetic resonance imaging: the visualization of tissues is carried out by the resonance of the nuclei of organic substances in a magnetic field.It involves scanning layer by layer, eliminating radiation exposure of the patient's body.

To determine the nature and severity of possible functional changes in the body, an additional examination is prescribed.It includes blood tests, urine tests, liver tests, kidney tests, and an electrocardiogram.Based on the analysis of all examination results, the doctor draws a conclusion and selects the appropriate treatment.

Treatment of the lumbar spine

Therapy for osteochondrosis of the lumbar spine is complex and includes several areas:

• General recommendations and diet.
• Drug therapy.
• Surgery.

The choice of direction of treatment is made by the doctor.Based on the results of clinical and additional examination, determines the optimal treatment.

General recommendations and diet

General recommendations should accompany the treatment of osteochondrosis of the lumbar spine, regardless of the severity of the pathological process, include:

• A balanced diet, limiting fatty fried foods and excluding alcohol from the diet.
• Limitation of heavy physical activity, including prolonged stay of the human body in one position.
• Rationalization of the work and rest regime: after each hour of work, a short rest should be provided (usually 10 minutes is sufficient).If you work standing or sedentary, you can do some exercise while resting.
• Give up bad habits, as nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilage tissue.
• Eliminate the impact of stressors and negative emotions that worsen the course of any pathological processes in the body.

Following general recommendations allows you to prevent the progression of the pathological process, as well as increase the effectiveness of other therapeutic areas.

Pharmacological treatment

Prescription of drugs is carried out during conservative treatment of osteochondrosis.

Drugs from various pharmacological groups are used:

• Nonsteroidal anti-inflammatory drugs: reduce the severity of the inflammatory reaction in the tissues and pain.Prescribed to reduce the intensity of manifestations of exacerbation of osteochondrosis.
• Muscle relaxants: The drugs reduce the tone of the striated muscles of the spine, thereby reducing tissue tension and compression of the spinal roots.
• Adrenal hormones and glucocorticosteroids – reduce the inflammatory response.
• Diuretics – reduce the severity of edema in the soft tissues of the area of \u200b\u200bthe spinal structures affected by the pathological process.Due to this, the manifestations of the pathological process are reduced and the violation of the spinal roots is reduced.
• Chondroprotectors are agents that protect cartilaginous tissue from damage and also contribute to its partial restoration.
• B vitamins: normalize metabolic processes in nervous tissue, improve the functional state of spinal roots damaged after strangulation.
• Vitamin C (ascorbic acid) – improves the conditions of microcirculatory structures, has an antioxidant effect, which is achieved by binding and neutralizing free radicals (“fragments” of organic molecules containing an unpaired electron and damaging the structures of the cell membrane).

The dosage and duration of use of the drug is determined by the attending physician based on the results of research, as well as the effectiveness of previous therapy.

Surgery

Surgery for osteochondrosis of the lumbar spine is indicated in case of pronounced changes, as well as in the absence of the necessary result after conservative therapy.It aims to eliminate defects in the altered cartilaginous tissue with subsequent plastic surgery.In modern medical institutions, surgery is performed using minimally invasive endoscopic techniques.Along with surgical treatment, drugs are prescribed that help speed up the healing process of the postoperative wound, as well as avoid the development of complications.Through the use of modern minimally invasive techniques it was possible to significantly reduce the time spent by the patient in hospital.

Prevention

Prevention of the development of osteochondrosis of the lumbar spine includes compliance with simple recommendations.It is important to limit the load on the spine, abandon bad habits, rationalize the work and rest schedule and ensure adequate sleep.The diet aims to limit fried and fatty foods and to ensure a sufficient intake of vitamins, minerals and vegetable fibres.This will allow you to normalize the functional state of the digestive system, as well as improve the nutrition of the cartilaginous structures of the musculoskeletal system, slowing down the processes of degeneration.

The prognosis for life with osteochondrosis of the lumbar spine is favorable.The disease is characterized by gradual progression.In the absence of therapeutic measures, the clinical picture of osteochondrosis is accompanied by an increase in symptoms.At the same time, the person's condition worsens and the manifestations become permanent.They bring considerable inconvenience and reduce the quality of life.To avoid the progression of negative manifestations, you should immediately seek qualified medical help.