Spinal osteochondrosis 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 increasingly being made to young people and even children. If osteochondrosis is left untreated, serious complications can develop.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used to help get rid of 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 at once. 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 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 heavier load, makes it a favorite "target" of osteochondrosis.
Initially the pathology concerns the intervertebral discs, which lose elasticity, become "dry" and decrease in height. Their shock-absorbing function is disrupted, causing the vertebrae to move closer together. The internal part of the intervertebral disc, called the nucleus pulposus, begins to swell due to its softness, pushing aside the fibrous ring that surrounds it. This is how bumps and hernias form. They can compress the longitudinal ligaments of the spine and the roots of the spinal nerves, 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. This primarily affects people with low physical activity and sedentary work. A passive lifestyle weakens the muscle corset and reduces the mobility of the spine. Because of this, the muscles lose the ability to maintain 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, obesity;
- endocrine diseases, hormonal imbalance;
- poor diet, insufficient intake of vitamins, proteins and minerals;
- burdened inheritance;
- excessive physical activity;
- back injuries;
- posture disorders;
- inflammatory joint diseases: arthritis, arthrosis;
- congenital anomalies of the spine;
- flat feet;
- pregnancy, especially multiple pregnancy.
Symptoms
The insidiousness 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 disappears 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 unpleasant sensations increases and to relieve them you need more rest or taking a painkiller.
Low 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 aching pain, which intensifies during physical activity, prolonged stay in a stationary position, sneezing and coughing. Sometimes the pain spreads to the leg, sacrum and buttocks. Unpleasant sensations disappear in the supine position. Sharp, sharp pain is often described by patients as a "thrust in the back. "
Other common complaints:
- stiffness and tension in the back muscles;
- reduced sensitivity in the lower extremities of varying severity, sensation of "goosebumps" creeping on the legs;
- limited mobility of the spine;
- change in gait, lameness due to severe back pain or leg pain;
- muscle weakness in the legs;
- rachiocampus;
- creaking 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 complemented 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 examination methods are performed to evaluate the condition of the spine and the body as a whole.
At the initial consultation, the doctor carries out:
- Survey.The specialist clarifies the complaints, the time of their onset and the presence of a connection with provoking factors: physical activity, prolonged static posture, sudden movement, hypothermia. He also studies medical documentation: medical reports and results of previous tests.
- Inspection. The doctor examines the skin and spine for visible lesions, damage, and deformities. Assess gait and limb symmetry.
- Palpation. During palpation of the spine, pain, the presence of compactions or deformities are revealed.
- Neurological examination. A consultation with a neurologist necessarily includes an assessment of the muscle strength of the limbs, sensitivity in them and the symmetry of tendon reflexes.
The patient is subsequently subjected to a more in-depth diagnostic examination. To evaluate 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 is confirmed by instrumental diagnostic methods:
- Radiograph in two projections. An X-ray image helps to evaluate the condition of the bones, identify anomalies in the development of the spine, detect formed osteophytes and pathological changes in the joints.
- CT. A slice-by-slice CT image allows you to study the spine in more detail. View vertebrae, bony growths, and other major defects. CT with intravenous contrast shows the condition of the blood vessels and blood circulation in the tissues.
- magnetic resonance imaging. The preferred diagnostic method, as it allows you to obtain a large amount of accurate information quickly and without radiation. An MRI image visualizes the condition of the cartilage, ligaments, intervertebral discs, spinal nerve roots, spinal cord and other soft tissues.
Which doctor should I contact?
Diagnosis and treatment of osteochondrosis are carried out by doctors of different specialties: neurologist, vertebrologist, orthopedic traumatologist. For therapeutic procedures, a physiotherapist, a masseur, an acupuncturist and a physiotherapy specialist are involved. Doctors of all these specialties work in clinics. Qualified specialists carry out 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 the visit to the doctor and sign up for a consultation in 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: this can aggravate 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,
- pregnancy and breastfeeding period.
Methods of treatment for osteochondrosis of the lumbar spine:
- Pharmacological therapy.
The type of drug, dosage, frequency and duration of administration are selected by the doctor. Depending on the clinical case, the following is 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, especially of the gastrointestinal tract and cardiovascular system.
- Muscle relaxants.Eliminates back muscle strain and reduces pain.
- Glucocorticosteroids.Sometimes used for severe pain and inflammation.
In case of intense pain, pharmacological blocks can be prescribed. The procedure involves injecting painkillers and anti-inflammatory drugs directly into the source of the pain, at a point located near 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.
Physiotherapeutic procedures improve well-being, enhance the effect of prescribed drugs and accelerate tissue regeneration. For osteochondrosis the following is recommended:
- shock wave therapy,
- magnetotherapy,
- laser therapy.
To achieve maximum therapeutic results, it is necessary to undergo a course of physiotherapy treatment consisting of several procedures. The doctor individually determines the duration and frequency of physical therapy.
- Massage therapy.
Massage is indicated outside the period of exacerbation. It is performed by a qualified masseur who chooses tactics for influencing the body taking into account medical history. You may feel better after the first session, but several procedures are needed to achieve lasting results. One of the main advantages of therapeutic massage is its additional impact on the psycho-emotional state. During the 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 that lead to the source of inflammation and pain. The method helps relieve pain, relax muscles and improve mobility of the spine.
- Therapeutic physical education (physical therapy).
Physical therapy is indicated during the period of remission, that is, when there is no acute pain. The exercises are intended to lengthen and relax the muscles of the spine, strengthening them and increasing the mobility of the spinal joints. Therapeutic gymnastics increases blood circulation and stimulates the metabolism, improving tissue nutrition.
Regular and correct physiotherapy, even at home, prevents exacerbation of the disease and the onset of pain attacks. 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 hernia formed that compresses the roots of the spinal nerves. As a result, the following neurological symptoms occur:
- 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, a phenomenon called discogenic myelopathy. In this case, persistent neurological symptoms develop, sometimes leading to disability, and among the complications of osteochondrosis it is worth highlighting spondylosis, which is stiffness of the joints between the vertebral arches. The disease leads to a strong limitation of spinal movements.
Another unpleasant complication is chronic pain syndrome, which lasts more than 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 when working in a sedentary manner and staying in a stationary position for a long time;
- appropriate nutrition;
- visit the swimming pool;
- yoga and pilates lessons;
- stop smoking and abusing alcohol;
- avoid heavy physical activity, especially heavy lifting;
- 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.