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 the result of a natural or unhealthy lifestyle. In old age, the involutionary processes of bone and cartilage tissue begin in all people. But when these phenomena are early (appearing in middle-aged people), we are talking about pathological processes in the skeletal system. The pathology affects men and women over 30 equally.
Lumbar osteochondrosis is the most famous and common disease of the spine, manifested by severe pain in the lumbar region. The disease is caused by metabolic disorders that lead to poor nutrition of cartilage and bone tissue, and waste products accumulate in the bone cells. This leads to pathologies of the intervertebral discs. In addition, their thickness and elasticity change, and then osteophytes (an increase in bone tissue that narrows holes formed in nerve endings) are formed in the vertebrae.
Causes of osteochondrosis of the lumbar spine
Lumbar osteochondrosis is much more common than osteochondrosis of the thoracic or cervical spine because the lower back has the greatest load during walking and running, sitting on a long chair or lifting weights.
Because this anatomical location bears the maximum load, its structure is very strong and reliable. The lumbar region consists of five vertebrae and connects the rib arch to the sacrum. Among them are intervertebral discs that provide flexibility and agility to the spine. The intervertebral discs, on the other hand, consist of a jelly-like nucleus located inside a hard annulus fibrosus. When osteochondrosis develops, the normal nutrition of the discs is disrupted, resulting in thinning, loss of elasticity, and a reduction in the distance between them. As a result, the nerve roots are damaged, leading to severe pain and even disability.
Therefore, the causes of the pathology are as follows:
- spinal cord injury;
- endocrine, gastrointestinal and cardiovascular diseases;
- intense physical activity (weight lifting, hard running);
- sedentary lifestyle;
- disorders of the hormonal system;
- goosefoot;
- anomalies of the intervertebral discs;
- old age;
- inflammatory diseases of the joints such as rheumatoid arthritis.
Risk factors for developing the disease include:
- bending and poor posture;
- improper lifestyle;
- unhealthy eating, obesity;
- improper posture for a long time;
- hereditary factor;
- tension;
- hypothermia.
The main symptom of the disease is lower back pain. It can be felt immediately or after intense physical activity.
Other symptoms of lumbar osteochondrosis include:
- aching pain radiating to the lower back;
- increased pain after weight lifting, sneezing, coughing, exercise;
- stiffness in the body after being in a position for a long time;
- persistent cramps in the back muscles;
- sudden painful sensation (lumbago) after body hypothermia;
- violation of sensitivity in the buttocks, thighs, lower legs and feet;
- paresis in the legs;
- coldness of the feet;
- spasm of the arteries of the foot;
- excessive sweating;
- dehydration and peeling of the skin in painful areas.
Osteochondrosis of the lumbar spine can be aggravated by any awkward movement, such as moving the body or turning it to the side. In this case, the pain is felt not only in the lower back but also in the legs. Lumbar spasm is also strong, as this relieves the body of this part of the body. During exacerbation, one finds a comfortable position in which the pain subsides.
One of the complications of osteochondrosis of the lumbar spine is a disorder of the urogenital system. Sometimes there is increased urination and discomfort in the kidney area. Inflammation of the sciatic nerve and lumbodynia (pain in the lower back) may be associated with the disease.
Stages of osteochondrosis of the lumbar spine
Unfortunately, osteochondrosis is an incurable disease and the process of destruction of intervertebral discs is irreversible. There are four stages in the development of osteochondrosis:
- The first stage at which the jelly-like core inside the disc changes and moves.
- The second stage is the period of destruction of the annulus fibrosus in the disc;
- Third degree, in which the annulus fibrosus ruptures and leaves the jelly-like nucleus, causing the formation of a disc herniation.
- The fourth stage is the developmental period of degenerative processes in the vertebrae involving the intervertebral joints and ligaments. Arthrosis of the intervertebral joints (spondyloarthrosis) develops.
First degree
It is characterized by painful sensations due to irritation of nerve endings in the annulus fibrosus and longitudinal ligaments. The patient feels pain and discomfort at the stage of the affected disc. The pain may be sharp, acute, or dull, permanent, and localized in the lumbosacral segment. It is very often released on the foot and is sometimes only felt on the foot.
Irritation of nerve endings leads to the development of reflex syndromes. Because of this, one does not always feel pain in the problem area, but goes far beyond it. In addition, violation of robots of internal organs, the occurrence of reflex muscle cramps; circulatory disorders in the extremities and ligaments. Violation of blood circulation and nutrition in tendons and ligaments, causing pain and hardening at the sites of attachment to the bones.
Secondary
At this stage, characteristic instability and increased mobility of the vertebrae are observed, leading to permanent lubrication of the muscles. At the same time, the person is having difficulty standing, feeling 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 a prolapse of the cartilage discs, manifested by compression of the nerve roots. During this period, a violation of sensitivity occurs in the innervation zone of the compressed nerve. In addition, discomfort occurs in the form of tingling, burning, numbness, and complete loss of sensitivity, which is associated with impaired motor function, which sometimes leads to paralysis. Muscle atrophy, thinning and shrinkage are observed in the affected area. The zones where the changes described above can be observed tell the location of the spinal cord injury. A characteristic manifestation of the third degree is the onset of Lasegue symptom. This is manifested as follows: if the patient is lying on his back, with his legs straight up, there is severe pain in the lumbar region that spreads to the back of the raised leg. When the legs are bent to the knees, the pain immediately subsides.
When fragments of the intervertebral discs fall into the lumen of the spinal canal, damage to the spinal cord occurs. Another syndrome, called ponytail, manifests as damage to the sensitivity and motor functions of the legs and pelvic organs and bladder.
Fourth grade
This period is characterized by the cessation of pain and the restoration of the locomotor system. However, the motor function is limited. The spine is said to become woody as disc fibrosis develops and all its elements are replaced by dense scar tissue. However, intervertebral ligaments and joints are involved in the inflammatory process, and different degrees of disease can be observed, manifested in a polymorphism of symptoms.
How to treat osteochondrosis of the lumbar spine
Treatment of osteochondrosis of the lumbar spine is a very long and long process. And most importantly, a lot depends on the person to successfully treat a disease. After all, you need to make a radical change in your lifestyle and get rid of many everyday habits, and work on your health throughout your life.
Otherwise, even successful medication cannot completely eliminate spinal deformities. In addition, after a temporary improvement, symptoms return to a new intensity and treatment should be started again. Although sometimes an attack of osteochondrosis occurs even with adherence to a system of physical activity.
Thus, osteochondrosis is treated in 3 ways:
- conservative drug treatment;
- not drugs;
- surgery.
Conservative medication
Because osteochondrosis of the spine is not completely curable and is an irreversible process, conservative treatment is intended to eliminate symptoms and prevent further progression of the disease. Physical activity should be kept to a minimum before starting medication. Bed rest is recommended for severe exacerbations. This is sometimes more effective than medication.
To relieve the symptoms of inflammation, use:
- NSAIDs (non-steroidal anti-inflammatory drugs). Medications from this group are effective in relieving pain and inflammation in the vertebrae. The drugs can be tablets or injections.
- Glucocorticosteroids. These drugs are classified as steroid hormones. Glucocorticosteroid injections are given directly into the joint cavity. It is supplemented without error with B vitamins (B1, B6, B12).
- Sedatives. They are needed to eliminate reflexogenic and related psychogenic disorders.
- Anticonvulsants. Eliminate involuntary contractions of skeletal muscles.
- Antidepressants. Drugs in this group affect the levels of neurotransmitters, resulting in improved patient mood, melancholy, anxiety, and emotional stress.
- Diuretic drugs. They are needed for signs of radical syndrome.
- Anticholinesterase drugs. Drugs in this group inhibit the activity of the enzyme cholinesterase, resulting in increased conduction of nerve impulses.
- Chondroprotectors. Necessary to prevent deformation of the discs and joints.
In the case of an acute attack, novocaine blockade is prescribed (introduction of anesthetics directly into the affected area).
Symptoms of lumbar osteochondrosis appear differently in women than in men. In women, the menstrual cycle can be disrupted and gynecological diseases can develop: inflammation of the ovaries and uterus (endometritis). Reproductive damage may also occur. In this 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 home treatment methods are used:
- Diet. Very often, osteochondrosis is caused by the accumulation of cholesterol and loss of vascular flexibility. A low-fat diet should be followed to remedy the situation. It also excludes foods high in cholesterol from the diet: eggs, pork, rich broth, chicken skin. Eliminate alcohol and nicotine completely, reduce your consumption of coffee and strong tea. They lead to vasospasm.
- Restoration of blood supply in the lumbar region. To do this, use both rubbing with ointments and compresses and physiotherapy exercises that you can do at home.
- Orthopedic sleep aids. Because the spine is the axis of the human body that is under tremendous strain during the day, it needs proper rest. In this quality, orthopedic mattresses and pillows work, which can give the spine a proper position during sleep.