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 40 years old, is characterized by gradual progression and therefore requires adequate conservative or surgical treatment.

Mechanism of development

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

The disease includes several pathogenetic links:

• Cartilage tissue dystrophy due to malnutrition is the main cause of the pathology.
• Degeneration (damage and destruction) of the cartilage of the spine (intervertebral discs, articular surfaces of the vertebral processes).
• An inflammatory reaction with tissue swelling, blood stagnation 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), leading 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, leading to the 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 makes it possible to slow down the progression of the disease.

reason

Osteochondrosis of the lumbar spine is a polyetiological disease that develops for several reasons:

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

The realization of the negative impact of the cause is more possible against the background of the following risk factors:

• Increased weight, which increases the load on the spine.
• Systematic long-term standing of the human body in a standing position.
• Wrong attitude.
• Hypothermia, including local in the back area.
• Systematic exposure to stress, lack of sleep, irrational work and rest regime.

Knowing the causes and risk factors will make it possible to take effective preventive measures.

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 first appears when the load on the spine increases.Then it becomes constant, has a pulling or aching character and gradually intensifies.
• Radiating pain in the leg on the side of the root of the compressed spinal cord.
• Increased tone (tension) of the back muscles in the lumbar region.
• Decreased muscle strength in one or both legs.
• Periodic "shooting" pain in the back, provoked by local hypothermia and physical exertion.
• Loss of skin sensation in one or both feet, which is accompanied by numbness and tingling.
• "Cold legs" - the skin becomes cold to the touch due to spasm of arterial vessels, which is caused by compression of the autonomic nerve fibers of the spinal roots.
• Impaired sweating - the skin of the feet becomes dry or, on the contrary, sweating increases.
• Peeling of the skin in the area of sensitivity disturbance 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 worsening of the pathology, which is accompanied by increased clinical symptoms.After exposure to a provoking factor (hypothermia, physical and emotional stress, stress), a sharp increase in pain in the form of an attack is possible, provoked by an inflammatory reaction and swelling of soft tissues in the area of the spinal roots.

Depending on the predominant symptoms, several clinical forms of the disease are distinguished:

• Lumbodynia is periodic paroxysmal pain in the lower back that develops after exposure to provoking factors.
• Lumboscalgia - pain occurs in the lower back and radiates to the buttocks or legs.
• Radiculitis is a pathological process associated with compression of one or more roots, while the clinical picture is dominated by neurological symptoms, including damage to skin sensitivity and decreased muscle strength.
• Radiculoischemia - compression affects the arterial vessels and severe motor disturbances 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 cartilage structures can lead to disability.

Diagnosing

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

For this purpose, several instrumental research methods are described:

• Radiography is a technique that allows you to visualize major changes.It has become widespread because of 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 - tissue visualization is performed due to the resonance effect of the nuclei of organic substances in a magnetic field.It involves scanning layer by layer while radiation exposure to the patient's body is eliminated.

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 chooses 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.
• Surgical intervention.

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

General recommendations and diet

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

• A balanced diet with the restriction of fatty fried foods and the exclusion of alcohol from the diet.
• Restriction of heavy physical activity, including prolonged standing of the human body in one position.
• Rationalization of the work and rest regime - after each working hour, a short break should be provided (usually 10 minutes is enough).If you work standing or sitting, you can do some exercise during your break.
• Giving up bad habits, as nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilage tissue.
• Eliminating the influence of stress factors and negative emotions that worsen the course of any pathological process in the body.

Following the general recommendations makes it possible to prevent the progression of the pathological process, as well as increase the effectiveness of other areas of therapy.

Drug treatment

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

Drugs of different pharmacological groups are used:

• Non-steroidal anti-inflammatory drugs - reduce the severity of the inflammatory reaction in tissues and pain.It is prescribed to reduce the intensity of worsening manifestations of osteochondrosis.
• Muscle relaxants - drugs reduce the tone of the striated muscles in 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 the spinal structures affected by the pathological process.Due to this, the manifestations of the pathological process are reduced and the damage to the spinal roots is reduced.
• Chondroprotectors are agents that protect cartilage tissue from damage and also contribute to its partial restoration.
• B vitamins - normalize metabolic processes in nerve tissues, improve the functional condition of spinal roots damaged after drowning.
• Vitamin C (ascorbic acid) – improves the condition of microcirculatory structures, has an antioxidant effect, which is realized by binding and neutralizing free radicals ("fragments" of organic molecules that contain an unpaired electron and that damage cell membrane structures).

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

Surgical intervention

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

Preventing

Prevention of the development of osteochondrosis of the lumbar spine involves following simple recommendations.It is important to limit the load on the spine, give up bad habits, rationalize the work and rest schedule and ensure adequate sleep.The diet aims to limit fried, fatty foods and ensure a sufficient supply of vitamins, minerals and plant fibers.This will make it possible 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 degeneration processes.

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