What is osteochondrosis of the lumbar spine?

Osteochondrosis of the lumbar region is a pathology of the musculoskeletal system, accompanied by degenerative-dystrophic changes in the bone tissue and impaired functioning of the five lower vertebrae (from 20 to 24). The disease causes discomfort to the patient and is characterized by specific symptoms - pain, stiffness of movements. Osteochondrosis of the lower back proceeds in waves, with periods of exacerbations and remissions. According to statistics, this form is one of the most common. Pathology, left without attention, often leads to irreversible changes and a significant deterioration in the quality of life. However, with a competent integrated approach, osteochondrosis can be successfully treated.

The main causes of the pathology

There are no exact data why degenerative-dystrophic changes in the spine are caused. It is assumed that the initial mechanism for the development of the pathology is the premature age-related changes in the joints. They can be genetically determined - transmitted by inheritance, but most often initially manifest under the influence of unfavorable factors.

The main one among them is considered to be an incorrect distribution of the load on the spine. Osteochondrosis of the lumbosacral spine can develop in:

• wearing high-heeled shoes;
• carrying a bag or backpack on one shoulder without alternating;
• sleeping or resting for a long time in an uncomfortable position;
• sedentary work;
• weight lifting.

Those at risk of developing osteochondrosis are the elderly, who are characterized by natural destructive changes in the cartilage and bone tissue, professional athletes who train daily and intensively, pregnant women, whose center of gravity shifts with the growth of the fetus and the load on the lower part of thethe body. the back increases significantly, office workers forced to spend a lot of time in a sitting position.

In addition to external risk factors, doctors also call a group of internal ones. These include:

• previous injuries of the musculoskeletal system;
• curvature of the spine;
• flat feet;
• congenital dislocation or subluxation of the hip joint;
• autoimmune disorders;
• inflammation of joint tissues;
• pathologies of the circulatory system;
• endocrine diseases;
• obesity.

Osteochondrosis of the lower back can also be provoked by intoxication and prolonged dehydration, bad habits, calcium deficiency and any mechanical impact on the lower back - bruises, blows, falls.

Osteochondrosis of the lumbar spine: symptoms

The pathology affects not only the bone tissue itself, but also the entire movement segment of the spine - vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Osteochondrosis of the lumbar spine develops gradually and slowly, the symptoms of which become apparent with significant damage. In the early stages it is moderate discomfort during physical exertion, in the later stages it is acute unbearable pain. Clinical signs are expressed in the acute stage. During the period of remission, they fade, and in the early stages this happens even without treatment.

Osteochondrosis of the lumbar spine - symptoms:

• pain in the affected area of the spine;
• radiating pain up to the shoulder blades or down to the pelvis and hip joints;
• constant feeling of tension in the lower back;
• difficulty bending and turning the body;
• a slob;
• lameness;
• muscle weakness or, conversely, increased tone;
• tingling.

Not always all the described symptoms appear at the same time. Pain may be associated with limited mobility, but not muscle weakness or numbness. Any of the signs discussed above will be a reason to consult a doctor.

Stages of the disease

The intensity of the symptoms that accompany osteochondrosis of the lumbosacral spine directly depends on the degree of development of the pathology. They are four in total.

1. First stage. The first structural and functional changes begin. Intervertebral discs dry out and can crack. Symptoms at this stage are minor. Many patients confuse them with fatigue after a day's work, wearing uncomfortable shoes or exercising. The main signs of early osteochondrosis are slight discomfort in the lower back, which increases when bending and turning. Slight pain is possible, which will subside on its own after rest.
2. Second stage. The height of the intervertebral discs decreases, the bone structures converge. This provokes a new round of symptoms - stiffness when moving and pain. The pain becomes prolonged and intense and may radiate to the pelvis and legs.
3. Third stage. At this stage the vertebrae are deformed. Protrusions are formed - the intervertebral discs protrude into the area of the spinal canal, but the fibrous rings remain intact. The main symptoms are severe pain, alarming even at rest, reduced sensitivity, crunching and clicking when moving, tingling and numbness in the lower back.
4. Fourth stage. Pathological changes continue to progress. The functions of the vertebrae are lost. Hernias form. Osteophytes are formed - bone growths. Blood vessels can be compressed and nerve fibers. Against the background of worsening blood circulation, the functioning of the pelvic organs is impaired. In men, the risk of erectile dysfunction increases, in women, menstrual cycle disorders are observed. Advanced osteochondrosis is manifested by sharp lumbago in the lower back, lameness, impaired mobility up to complete immobility and fever.

If you are concerned about lumbar osteochondrosis, its treatment will depend directly on the stage at which the disease was diagnosed. In the early stages, the doctor has many more recovery methods and techniques in his arsenal. The detection of degenerative-dystrophic changes in the initial stages makes it possible to treat the pathology conservatively without resorting to surgical intervention.

Forms of pathology

The division of forms is based on the characteristics of the pain syndrome that always accompanies osteochondrosis of the lumbar sacral spine. There are three in total:

1. Lumbago. It is a sharp shooting pain that makes movement impossible. The causes of the pain can be pinched nerves or muscle spasms.
2. Lumbodynia. It's long-term, painful pain. It is characteristic of the stage of formation of protrusions and hernia. Also, discomfort can be associated with stretched ligaments.
3. sciatica. This is a severe pain that spreads to the pelvic area. The patient complains of pain when walking, sitting or changing body position.

Depending on the accompanying symptoms, two more forms of pathology are distinguished. The patient may be diagnosed with:

1. Radiculopathy. Accompanied by compression of nerve endings due to deformation of the vertebrae. In this form of the disease, sensitivity decreases and the affected area becomes numb. Soreness and numbness are expressed. Possible decrease in muscle tone, impaired reflexes, numbness of the legs.
2. Discogenic lumbar osteochondrosis. This is a serious condition where the patient is limited in movement. His lower back and limbs are numb. Other symptoms are general weakness, fever, involuntary urination, and in prolonged illness - weight loss.

Danger of spine disease

If left untreated, osteochondrosis is fraught not only with unbearable pain and stiffness of movements, but also with a number of pathologies that can develop against its background. The most common complications:

• intervertebral hernia;
• inflammation of the sciatic nerve;
• sciatica;
• paresis.

In order to prevent concomitant pathologies, it is necessary to start the treatment of osteochondrosis immediately from the moment of detection. With a competent approach to therapy, it is possible to stop or significantly slow down the destruction of bone and cartilage tissue.

Pathology diagnosis methods

Osteochondrosis of the lumbar sacral spine must be differentiated from other pathologies of the musculoskeletal system, which may present with similar symptoms. The first stage is a consultation with a neurologist, orthopedist or surgeon. The doctor clarifies the complaints, collects an anamnesis, conducts a physical examination, paying attention to the characteristics of the patient's posture and posture, the nature of his work, bad habits and concomitant diseases.

Instrumental techniques are used for the most accurate diagnosis:

• MRI;
• radiography;
• myelography with contrast agent;
• multislice CT.

Each of the diagnostic procedures allows the doctor to assess the condition of the lumbar and sacral spine at the moment. The images clearly show structural changes in the vertebrae indicating the stage of osteochondrosis. Based on the received data, the specialist decides on the tactics for further treatment of the patient.

Laboratory diagnosis is not key, but investigations may be recommended if indicated. In particular, if lumbar osteochondrosis is diagnosed, treatment can be prescribed based on the results of blood tests. They are necessary to clarify the intensity of inflammatory processes in the muscle fibers adjacent to the spine.

Lumbar osteochondrosis: treatment

The fight against pathology is carried out under the supervision of a neurologist and begins after a comprehensive diagnosis, when the extent and degree of tissue damage is determined. Modern medicine offers a number of effective conservative methods. If their use does not lead to the expected result, doctors resort to surgery.

Lumbar osteochondrosis: treatment with physiotherapeutic methods

All physiotherapy techniques are good because they affect the sacral and lumbar spine in a holistic way. This approach allows you to cope with pain, reduce inflammation and restore normal blood circulation.

When osteochondrosis of the lumbar spine progresses, treatment must be comprehensive. Patients with complaints are prescribed:

• electrophoresis - exposing the problem area to constant electric pulses with the possibility of using drugs for external use;
• diadynamic therapy - a variant of electrotherapy using pulsed currents;
• magnetotherapy – treatment with alternating or static magnetic fields;
• ultrasound therapy - the impact of high-frequency sound waves;
• shock wave therapy - impact of low-frequency acoustic pulses;

It is important to consider two nuances. First, the effect of physiotherapy treatment is noticeable only after a course of procedures, the duration of which is selected individually for each patient. The second is that physiotherapy as an independent method works for osteochondrosis in the initial stage. In large-scale lesions, it is recommended as an auxiliary technique in addition to medical and surgical treatment.

Lumbar osteochondrosis: drug treatment

Pharmacotherapy for lesions of the lumbar and sacral spine is aimed at alleviating acute pain and suppressing inflammatory processes. The method is suitable in the acute stage, when the symptoms interfere with a full life.

How to treat lumbar osteochondrosis with drugs is always decided individually. The neurologist can prescribe drugs from different pharmacological groups. Main:

• NSAIDs (systemic and local) to suppress inflammation in the vertebrae and adjacent tissues;
• muscle relaxants to relieve muscle spasms;
• angioprotectors to improve blood circulation;
• chondroprotectors to protect the cartilage tissue of the intervertebral discs from destruction;
• B vitamins to improve nerve conduction;
• analgesics for sharp shooting pains that limit mobility.

Exercise therapy as a method of treating pathology of the sacral and lumbar region

Intensive training for osteochondrosis is strictly prohibited, but you cannot completely give up physical activity. On the contrary, exercise of moderate intensity and duration helps restore blood circulation and reduce pain.

How to treat osteochondrosis of the lumbar spine with exercises:

1. Train with an instructor. The trainer will show you which exercises are allowed in a specific situation and make sure they are performed correctly. Even the smallest flaws in technology can significantly reduce the effectiveness of training or even cause harm.
2. Prepare carefully for the lesson. Before training, it is recommended to warm up the muscles - you can gently massage the lower back and sacrum.  
3. Strictly dose the load. The lower back is a vulnerable area. To avoid overexertion, you need to monitor the length of classes. Their optimal duration is no more than 20 minutes.
4. Gradually increase the intensity of the exercises. Simple exercises and short programs are suitable for beginners without experience. For those who have already been doing exercise therapy for a while, you can move on to more complex options.
5. Remember to be regular. One-time training will not lead to visible improvements. Pain in the lumbar and sacral spine decreases if the patient regularly engages in exercise - ideally twice a week.
6. Consider the contraindications. Physiotherapy has proven to be a safe method of treating osteochondrosis, but it has limitations. You should stop exercising if you feel unwell: fever, weakness or a rise in temperature.

Lumbar osteochondrosis, the treatment of which should take into account the period of the disease, will not bother you if all the rules are strictly followed.

1. In the acute period. Only smooth and slow movements are allowed. If the pain increases during exercise, you should stop and rest the joints.
2. In the subacute period. Pain syndrome decreases, mobility is restored, so you can slightly increase the intensity of training and increase its duration. But to avoid deterioration, you need to carefully monitor your well-being.
3. In remission. We allow the full range of exercises for pathologies of the lumbar spine, but it is important to remember that overexertion is fraught with a new exacerbation of the disease.

If lumbar osteochondrosis is diagnosed with mild or moderate severity, treatment with physical education can be carried out at home. After perfecting the exercise technique under the supervision of an instructor, repeating the exercises at home is not prohibited. For training, you will need a gymnastic mat, a roller and a ball.

Modern halls for treatment and rehabilitation therapy are equipped not only with traditional accessories, but also with special medical simulators. They help you recover from illness gently and safely, and also make activities more fun and interactive. For example, the neuromuscular rehabilitation system turns rehabilitation into an exciting competition with oneself. The patient stands on a movable platform and performs the exercises presented on the screen. Another important advantage of the simulator is the ability to track even the smallest progress in the patient's condition. The system evaluates the result of each exercise performed and the doctor can see the progress from exercise to exercise. Knowing one's own success also motivates patients to try harder and not give up.

Manual therapy

Good results can be achieved if you supplement exercise therapy and medications for lumbar pathology with manual therapy. The method allows:

• elimination of hypertonicity of muscle fibers;
• relieve pain;
• restoration of blood supply in the lumbar and sacrum areas;
• improving the course of metabolic processes.

Manual therapy is an effective way to properly redistribute the load on the spine and prevent further destructive changes. The good thing about this method is that it not only relieves pain, but also prevents neurological disorders that often develop against the background of lumbar osteochondrosis.  

Currently, chiropractors combine massage and physical therapy methods, such as thecartherapy. Electromagnetic waves penetrate deep into the bone tissue and allow you to relieve pain attacks and quickly restore mobility.  

Surgical methods

Osteochondrosis of the lumbar spine, the treatment of which with drugs, physiotherapy and exercise therapy is not always effective, significantly complicates the patient's life. In some cases, only surgical intervention is applicable to eliminate pain and restore back mobility. Modern methods and technological equipment allow performing minimally invasive operations with a shortened rehabilitation period.

The following methods of intervention are suitable for osteochondrosis:

• endoscopic excision of an intervertebral hernia - with the help of microsurgical instruments and a built-in camera;
• transfacet removal of intervertebral hernia - by means of neurosurgical tubular dilators;
• laminectomy - surgical removal of pathologically changed bone processes;
• microdiscectomy - removal of the protrusion of the hernia.

Direct indications for surgical intervention are recurrent hernias, spinal stenosis, when the spinal canal narrows, and degenerative spondylolisthesis, a pathology in which the vertebrae are displaced relative to each other. In all other cases, if osteochondrosis of the lumbar spine is confirmed, doctors try to carry out treatment using conservative methods.

Disease prevention

The symptoms of osteochondrosis cause inconvenience, and the treatment of the pathology can take a long time. It is much more effective to protect the vulnerable lumbar region from overstrain in advance. For preventive purposes, it is recommended:

1. Properly organize your workplace during office work. The back of the chair should support the lower back and the table should be the right height.
2. Avoid uncomfortable shoes. The optimal height of the current for women is up to 5 cm. It is also advisable to exclude flat soles, as they contribute to leg deformation and flat feet - one of the factors.
3. risk of osteochondrosis.
4. Exercise. Lifting heavy objects should be avoided. Swimming, walking and cardio training are useful if there are no contraindications.
5. Eat a balanced diet. The diet should contain foods that are sources of calcium, phosphorus and B vitamins. These are fish, dairy products, leafy vegetables and grains. These substances are necessary to strengthen all elements of the joints and maintain the nervous system.
6. Make sure you get enough sleep. It is better to sleep on an orthopedic mattress with medium hardness. It will provide an anatomically correct posture where the body rests from daily stress.
7. Control your body weight. Obesity is one of the provoking factors. If the weight is normal, the load on the spine will be distributed adequately and the risk of circulatory disorders will be minimized.

The prognosis for patients with osteochondrosis directly depends on the degree of damage to the vertebrae. That is why timely diagnosis is extremely important. If you are worried about pain in the lower back and the images show destructive processes in the initial stages, you should start treatment. In the early stages, drugs and physical therapy are effective. In later cases, it is rarely possible to do without surgery. Exercise therapy can be used as an additional measure of help in any form and at any stage.