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 adults and the elderly are susceptible to the disease. But in recent years, this diagnosis is being made more and more among young people, even among children. If osteochondrosis is not treated, serious complications can develop.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used to help relieve 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 more often it 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 heavier load, makes it a favorite "target" of osteochondrosis.
Initially, the pathology concerns the intervertebral discs, which lose their elasticity, "dry up" and decrease in height. Their shock-absorbing function is interrupted, 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 aside the fibrous ring that surrounds it. This is how protrusions and hernias are formed. They can compress the longitudinal ligaments of the spine and the nerve roots of the spine, 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 impact 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 core and reduces the mobility of the spine. Due to this, the muscles lose the ability to keep the spine in the correct physiological position, which leads to its rapid wear.
The main risk factors for the development of osteochondrosis include:
- frequent lifting of heavy objects;
- overweight, overweight;
- endocrine diseases, hormonal imbalance;
- poor nutrition, insufficient intake of vitamins, proteins and minerals;
- difficult inheritance;
- excessive physical activity;
- back injuries;
- posture disorders;
- inflammatory diseases in the joints: arthritis, arthrosis;
- congenital abnormalities of the spine;
- flat feet;
- pregnancy, especially multiple pregnancy.
Symptoms
The cunning of osteochondrosis is that it can be asymptomatic for many years. At first it is a slight pain and discomfort in the lower back, which passes on its own after a short rest. Typically, patients do not pay attention to these signs and do not consult a doctor. But gradually the intensity of the unpleasant sensations increases and for their relief more rest or taking a sedative is required.
Back pain with 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 painful pains, which intensify during physical activity, prolonged stay in a stationary position, sneezing and coughing. Sometimes the pain spreads to the legs, sacrum and buttocks. Unpleasant sensations go away in a lying position. Often acute 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 extremities of varying severity, a feeling of creeping "goosebumps" in the leg;
- limited mobility of the spine;
- change in gait, limp due to severe back pain or leg pain;
- leg muscle weakness;
- rachiocampsis;
- crackling 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 supplemented by some gynecological diseases and infertility, and in men - infertility and erectile dysfunction.
Diagnosing
The diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. In addition, laboratory and instrumental examination methods are performed to assess the condition of the spine and the body as a whole.
In the initial consultation, the doctor performs:
- Survey.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 - doctor's reports and results of previous examinations.
- Inspection. The doctor examines the skin and spine for visible injuries, damage and deformities. It assesses gait and limb symmetry.
- Palpation. During the palpation of the spine, pain, the presence of compressions or deformations are revealed.
- Neurological examination. A consultation with a neurologist necessarily includes an assessment of the strength of the muscles of the limbs, the sensitivity in them, 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 analysis of urine.
Intervertebral osteochondrosis of the lumbar region is confirmed by instrumental diagnostic methods:
- X-rays in two projections. An X-ray image helps to assess the condition of the bones, to identify anomalies in the development of the spine, to detect the formed osteophytes and pathological changes in the joints.
- c T. A layer-by-layer CT image enables a more detailed study of the spine. It visualizes vertebrae, bone growths and other significant defects. CT scan with intravenous contrast shows the condition of the blood vessels and blood flow in the tissues.
- MRI. The preferred diagnostic method, as 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. For therapeutic procedures, a physiotherapist, massage therapist, acupuncturist and physical therapy specialist are involved. Doctors of all these specialties work in clinics. Qualified specialists perform a comprehensive examination and prescribe effective treatment individually for each patient.
It is important not to self-medicate, but immediately seek professional help. 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 register 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 health,
- the presence of concomitant diseases,
- period of pregnancy and lactation.
Methods of treatment for osteochondrosis of the lumbar spine:
- Drug therapy.
The type of drug, its dose, 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 associated 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 sedatives and anti-inflammatory drugs directly into the source of the pain - at a point located near 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, increase the effect of prescribed drugs and accelerate tissue regeneration. For osteochondrosis, the following are recommended:
- shock wave therapy,
- magnetic therapy,
- laser therapy.
To achieve maximum therapeutic results, it is necessary to undergo a course of physiotherapeutic treatment consisting of several procedures. The doctor determines the duration and frequency of physical therapy individually.
- Massage therapy.
Massage is indicated outside the period of irritation. 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 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 - the hormones of pleasure and joy - are released.
- 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 relieve pain, relax muscles and improve mobility of the spine.
- 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 muscles of the spine, strengthening them and increasing the mobility of the joints of the spine. Therapeutic gymnastics increases blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and proper physiotherapy, even at home, prevents the exacerbation of the disease and the occurrence of a pain attack. 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 compresses the nerve roots of the spine. As a result, the following neurological symptoms appear:
- paresis or paralysis of the lower extremities, most often of the legs;
- 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 noting spondylosis - this is the stiffness of the joints between the vertebral arches. The disease leads to a sharp limitation of movements in the back.
Another unpleasant complication is chronic pain syndrome, which lasts over 12 weeks and disrupts the psycho-emotional state of the patient.
Preventing
The following will help prevent the development and progression of lumbar osteochondrosis:
- regular physical activity, gymnastics;
- body weight control;
- warming up every hour when you work sitting and stay in a stationary position for a long time;
- proper nutrition;
- visiting the pool;
- yoga and pilates courses;
- smoking cessation and alcohol abuse;
- avoiding heavy physical activity, especially heavy lifting;
- minimizing stress.
Timely visit to the clinic can prevent dangerous complications of osteochondrosis. The prescription of 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.