Osteochondrosis of the lumbar spine is a pathological change in the cartilage and bone tissue of the intervertebral discs in the lumbosacral spine. This change can be natural or the result of an unhealthy lifestyle. In old age, all people begin involutional processes of bone and cartilage tissue. But when these phenomena are premature (they appear in middle-aged people), then we are talking about pathological processes of the skeletal system. The pathology affects both men and women over the age of 30.
Lumbar osteochondrosis is the best known and most common disease of the spine, which is manifested by severe pain in the lumbar region. The disease develops as a consequence of metabolic disorders, which leads to inadequate nutrition of cartilage and bone tissue, and waste products accumulate in bone cells. This leads to pathology of the intervertebral discs. In addition, their thickness and flexibility change, and then osteophyte-like growths form on the vertebrae (growth of bone tissue, leading to narrowing of holes for nerve endings).
Reasons for the development of osteochondrosis of the lumbar spine
Osteochondrosis of the lumbar region occurs much more often than osteochondrosis of the thoracic or cervical spine, because the lower back has the greatest load when walking and running, with prolonged sitting on a chair or lifting weights.
Since this anatomical site takes the maximum load, its structure is very solid and reliable. The lumbar region consists of five vertebrae and connects the chest with the sacrum. Among them are intervertebral discs that give the spine flexibility and mobility. In turn, the intervertebral discs consist of a jelly nucleus, which is located inside the hard fibrous ring. When osteochondrosis develops, the normal nutrition of the discs is disrupted, causing them to become thinner, lose elasticity, and the distance between them decreases. As a result, nerve root damage occurs, leading to severe pain and even disability.
Therefore, the reasons for the development of this pathology are:
- spinal cord injury;
- diseases of the endocrine, digestive and cardiovascular systems;
- intense physical activity (weight lifting, heavy running);
- sedentary lifestyle;
- disorders of the hormonal system;
- flat feet;
- anomalies of the intervertebral discs;
- age;
- inflammatory joint diseases, such as rheumatoid arthritis.
Risk factors for disease development are:
- stooping and poor posture;
- wrong way of life;
- unhealthy diet, obesity;
- long time in the wrong position;
- hereditary factor;
- stress;
- hypothermia.
The main symptom of the disease is pain in the lower back. It can be felt immediately or after intense physical activity.
Other symptoms of lumbar osteochondrosis are:
- aching pain that spreads to the lower back;
- increased pain after lifting weights, sneezing, coughing, body movements;
- body stiffness after a long stay in one position;
- persistent spasms of the back muscles;
- sudden painful sensation (lumbago) after hypothermia of the body;
- violation of the sensitivity of the buttocks, thighs, lower legs and feet;
- paresis in the legs;
- cold feet;
- spasm of the arteries of the feet;
- excessive sweating;
- dryness and peeling of the skin at the sites of pain.
Osteochondrosis of the lumbar spine can be exacerbated by any awkward movement, for example, when moving or turning the body to the side. In this case, the pain is noticed not only in the lower back, but also in the legs. There is also a strong lumbar spasm, because in this way the body relieves this part of the body. During the exacerbation, the person finds a comfortable position for himself in which the pain decreases.
One of the complications of lumbar spine osteochondrosis is a malfunction of the genitourinary system. Sometimes there is increased urination and discomfort in the kidneys. Diseases may be accompanied by inflammation of the sciatic nerve and lumbodia (pain in the lower back).
Phases of osteochondrosis of the lumbar spine
Unfortunately, osteochondrosis is an incurable disease, and the process of destroying intervertebral discs is irreversible. There are four stages of osteochondrosis:
- The first stage, in which the milk nucleus inside the disc changes and moves.
- The second stage is the period of destruction of the fibrous annulus in the disc;
- The third stage, in which the annulus fibrosus bursts and the jelly-like nucleus leaves it, causes the formation of a herniated disc.
- The fourth stage is the period of development of degenerative processes of the vertebrae with involvement of the intervertebral joints and ligaments. Arthrosis of the intervertebral joints (spondyloarthritis) develops.
First degree
It is characterized by painful sensations due to irritation of nerve endings located in the annulus fibrosus and longitudinal ligaments. The patient feels pain and discomfort in the part of the affected disc. The pain can be sharp, acute or dull, it is permanent and localized in the lumbosacral segment. Very often it betrays the leg, and sometimes it is felt only in the leg.
Irritation of nerve endings leads to the development of reflex syndromes. For this reason, a person does not always feel pain in the problem area, but far beyond it. Also, there is a violation of the robot internal organs, the appearance of reflex muscle spasm; circulatory disorders in limbs and ligaments. Disorders of circulation and nutrition of tendons and ligaments, which leads to pain and induration in the places of attachment to bones.
Second degree
In this phase, there is a characteristic instability and increased mobility of the vertebrae, which leads to persistent lubrication of the muscles. At the same time, the man finds it difficult to stand, feels discomfort and pain in the lower back. Sometimes the lower back "hurts" and the patient doesn’t understand why.
Third degree
It is characterized by prolapse of disc fragments, which is manifested by compression of nerve roots. During this period, there is a violation of sensitivity in the zone of innervation of the compressed nerve. In addition, there are unpleasant sensations in the form of tingling, tingling, numbness, as well as complete loss of sensitivity, which is accompanied by impaired motor function, which sometimes leads to paralysis. Muscle atrophy, thinning and shrinkage are observed in the affected area. The zones in which the changes described above are eloquently indicate the location of the spinal lesion. The characteristic manifestation of the third degree is the appearance of Lasegue's symptom. It manifests itself as follows: when the patient lies on his back, legs straightened, there is severe pain in the lumbar region that spreads along the back of the raised leg. When the legs are bent at the knees, the pain stops immediately.
When fragments of intervertebral discs fall into the lumen of the spinal canal, spinal cord damage occurs. The second syndrome, the so-called ponytail, is manifested by impaired sensitivity and motor function of the legs, as well as the pelvic organs and the bladder.
Fourth degree
This period is characterized by the disappearance of pain and the restoration of the function of the musculoskeletal system. However, at the same time there is a limitation of motor function. The spine, so to speak, becomes wooden, as disc fibrosis develops and all its elements are replaced by dense scar tissue. At the same time, intervertebral ligaments and joints are involved in the inflammatory process, and different degrees of the disease are observed, which are manifested by a polymorphism of symptoms.
How to treat osteochondrosis of the lumbar spine
The treatment of osteochondrosis of the lumbar spine is a very long and persistent process. And most importantly, for the successful treatment of a disease much depends on the person himself. After all, he will have to radically change his lifestyle and get rid of many everyday habits, as well as work on his health for the rest of his life.
Otherwise, even successful drug treatment will not be able to completely eliminate the spinal deformity. In addition, after a temporary improvement, the symptoms will return with new intensity and treatment will have to start all over again. Although sometimes, even with respect to the regime of physical activity, attacks of osteochondrosis occur.
Thus, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug treatment;
- non-drugs;
- operation.
Conservative drug treatment
Because osteochondrosis of the spine cannot be completely cured and is an irreversible process, the goal of conservative treatment is to eliminate the symptoms and prevent further progression of the disease. Physical activity should be minimized before starting drug treatment. In case of severe exacerbations, bed rest is recommended. This is sometimes more effective than medication.
To relieve the symptoms of inflammation, use:
- NSAIDs (non-steroidal anti-inflammatory drugs). Drugs of this group effectively eliminate pain and inflammation in the vertebrae. Medications can be in tablets or injections.
- Glucocorticosteroids. These drugs are classified as steroid hormones. Glucocorticosteroid injections are given directly into the joint cavity. They are definitely supplemented with B vitamins (B1, B6, B12).
- Sedatives. They are necessary for the elimination of reflexogenic and associated psychogenic disorders.
- Anticonvulsants. Eliminate involuntary contractions of skeletal muscles.
- Antidepressants. Drugs of this group affect the level of neurotransmitters, as a result, the patient's mood improves, melancholy, anxiety and emotional stress disappear.
- Diuretics. They are necessary for the signs of radicular syndrome.
- Anticholinesterase drugs. Drugs of this group inhibit the activity of the enzyme cholinesterase, which increases the conduction of nerve impulses.
- Chondroprotectors. Needed to prevent deformation of vertebral discs and joints.
In an acute attack, blockade of novocaine is prescribed (ingestion of anesthetics directly into the affected area).
The symptoms of lumbar osteochondrosis in women manifest differently than in men. In women, menstrual disorders can occur, as well as the development of gynecological diseases: inflammation of the ovaries and uterus (endometritis). Reproductive damage may also occur. In that case, you need the help of a qualified gynecologist.
How to treat lumbar osteochondrosis at home
The main principle of home treatment is to eliminate the symptoms that prevent a person from living a quality lifestyle.
The following treatment methods are used at home:
- Diet. Very often the cause of osteochondrosis is the accumulation of cholesterol and loss of vascular elasticity. In order to improve the situation, it is necessary to adhere to a low-fat diet. Also exclude from your diet foods high in cholesterol: eggs, pork, rich soups, chicken skin. Eliminate alcohol and nicotine completely, reduce the consumption of coffee and strong tea. They lead to vasospasm.
- Restoration of blood supply in the lumbar region. To do this, use rubbing with healing ointments and compresses and physiotherapy exercises that can be performed at home.
- Orthopedic sleeping aids. Since the spine is the axis of the human body, which is subjected to enormous stress during the day, it needs proper rest. Orthopedic mattresses and pillows act in this capacity, which are able to give the spine the correct position during sleep.