Lumbar osteochondrosis: causes, symptoms, diagnosis, treatment

Lumbar osteochondrosis is a dangerous disease of the spine, characteristic of people who have reached the age of 35 and older. Natural wear and tear of the joints causes the development of pathology. Untimely access to a rheumatologist, in most cases, leads to disability. Modern medicine offers many effective methods of treatment in the primary stages. Early diagnosis is the key to a healthy life without limits.

Lumbar osteochondrosis - general definition

Osteochondrosis of the lumbar spine is a dystrophic process of degeneration in the formations of intervertebral cartilage - discs.

Discs provide the main functions of the spine - the ability to move and bend, stress resistance. As a result of the pathology, important elements become thinner, deformed, vertebrae are straightened, nerve endings and blood vessels are constricted. Negative processes are accompanied by feelings of pain of varying intensity and limitation of motor function.

Pathology causes changes in the connecting elements of the spine - cartilage, bones, discs and joints. This is caused by natural wear and tear, as well as acquired joint diseases or the result of an improper lifestyle.

Causes

There can be many reasons for the development of lumbar osteochondrosis:

• Natural or premature wear of the body;
• Excessive load on the lower back - lifting weights, working "on your feet" or sedentary, "sitting" lifestyle;
• Genetic predisposition to joint diseases, such as rheumatoid arthritis;
• Violation of metabolism, resulting in the accumulation of toxic substances in the connective discs;
• Chronic diseases of the circulatory system. Nutrients and trace elements stop entering the cartilage tissue in the appropriate amount. Hypoxia occurs, which contributes to the destruction of the intervertebral joints;
• Autoimmune pathologies.

Secondary factors can also cause the development of lumbar osteochondrosis:

• Chronic injuries, bruises on the back;
• Exceeding the weight norm by more than 15-20%;
• Heavy or powerful sports;
• Constant wearing of uncomfortable shoes. High heels, tight shoes, rubber or sports shoes are the first enemies of the spine;
• Valgus changes in the foot;
• Scoliosis, kyphosis, diabetes mellitus, spinal tuberculosis;
• Influence of low temperatures.

Clinical picture

The symptoms of lumbar osteochondrosis depend entirely on which nerve roots are affected by the disease. The degree of compression of the vertebrae, the stage of the disease and the damage to the disc determine the signs.

Rheumatologists distinguish the following main symptoms:

• Injury of tactile sensitivity in the lumbar region. Numbness extends to the inside of the thighs and groin. It can affect one or both limbs;
• There is a sharp, shooting pain in the lower back. The big toe completely loses mobility and characteristic numbness is observed;
• Loss of normal foot function, sensitivity of the toes, lower legs and outer thighs. Toning and regular seizures occur in these parts of the leg. There is no Achilles reflex on examination;
• If the disease affects the lower radicular artery, then there is complete paralysis of the muscles of the buttocks, back of the thighs and perineum. There is a serious violation of motor function, up to complete immobility.

Lumbar osteochondrosis affects not only the nerve endings of the spine, but also the blood vessels.

The following specific signs depend on the type of lesion:

• When only the nerve roots are disturbed, a change in the patient's gait is observed. The pain is localized not only in the lumbar zone, but also in all parts of the legs. Radicular syndrome is characterized by constant pain. Usually only on one side. Tingling and pain are noticed in the lower back. The pain can be relieved with a little exercise.
• Compression of blood vessels leads to perfusion in the hip area. As a result, the spinal discs starve. Painful sensations occur when walking in the buttocks, thighs and lower back. Completely removed after a night's rest.

Simultaneous violation of the functionality of blood vessels and nerve roots can lead to irreversible deformation of the discs. Prickly bony outgrowths form in the mobile joints of the lower back. This leads to severe pain and prevents normal natural movement. Impaired posture, gait. As it progresses, complete paralysis can occur.

Stages of the disease

Lumbar osteochondrosis develops gradually, in several stages. Each phase has its own characteristics, which determine the degree of progress.

• I stage.The slow destruction of the intervertebral discs begins. The process can take from a few months to 2-5 years. It is manifested by minor pain, discomfort in the inguinal and femoral muscles. It is noticed when walking or changing the weather.
• Phase II.The collagen fibers of the fibrous rings of the spine are drawn into the negative process. The space between the individual vertebrae decreases rapidly. Friction occurs, which causes strong attacks of pain. Impaired gait, posture, bending appear. Lumbar osteochondrosis is most commonly diagnosed in the second stage of the course.
• Phase III.An intervertebral hernia appears. And if the patient was not forced to seek medical help with phase II symptoms, then it will no longer be possible to ignore the terrible pain of the third phase. Deformation of the bones and joints of the spine in the lumbar zone is already irreversible. Walking requires a lot of effort. This is due to the pain and the inability to alleviate it with conventional pain medications.
• Stage IV.Partial or complete impairment of motor function. At this stage, the patient is assigned a disability group. Threatens complete paralysis. Vital activity is impossible without taking a wide range of medications.

Diagnostic measures

Diagnostic measures include several techniques and begin with collecting a complete medical history. During the initial consultation with a rheumatologist, the following information is clarified:

1. The patient's complaints are carefully analyzed - the place of localization of pain, where discomfort is still felt, in which parts of the hip joint there is a feeling of heaviness, convulsions, etc. ;
2. Duration, regularity, nature of pain;
3. When the first, even minor symptoms appeared. How much time has passed since the last attack, what causes discomfort and what factors contribute to its elimination;
4. The patient's living conditions. Profession, job, household workload, sports and the presence of additional factors for increased physical activity (dacha, garden, hobbies related to weight transfer);
5. An overview of the patient's medical history in the past or present.

After collecting the clinical picture, the rheumatologist proceeds directly to the external examination. During the examination, the gait, anatomical position of the legs, arms, torso, in relation to the spine are analyzed. The skin is examined for changes - pigmentation, peeling, eczema, rashes, etc. An assessment of motor function is given.

By performing simple exercises - leaning forward, backward, raising the arms and legs, turning the head, rotational movements of the pelvis, the patient allows the doctor to determine the degree of damage to the spine in the lumbar region.

Final measures of external inspection are actions to determine the degree of radicular damage:

• Lasegue symptom.Lying on his back, the patient alternately raises his legs, bent at the knee. If this causes lower back pain, the readings are considered positive.
• Dejerina's symptom.The patient is asked to tighten the abdominal muscles as much as possible. The appearance of discomfort in the spine indicates the development of lumbar osteochondrosis.
• Neri's symptom. Sharp tilts of the head back and forth respond with pain in the lower back.
• Wasserman's symptom. The patient, lying down, moves his leg as far to the side as possible. In the presence of pathology, unpleasant pain occurs in the groin and front of the thigh.

To confirm or rule out a diagnosis, the patient is referred to an instrumental diagnosis. MRI is considered to be the most effective way to determine lumbar osteochondrosis. The study shows the distance between the vertebrae, the development of neoplasms and bone deformities. It may be contraindicated in patients with mental disorders.
Computed tomography gives a fairly true picture of the disease in one plane - horizontal or vertical.
X-rays are used only in the last stages, when irreversible changes in the bone tissue of the spine begin.

Complex treatment of lumbar osteochondrosis

The causes of the pathology have not been fully elucidated. Scientific research in the field of spinal joint diseases has not yet identified sufficiently effective methods for complete restoration of intervertebral discs. Modern methods of treatment are aimed only at removing the external signs of the disease. Complete recovery is currently considered impossible.

Traditional drug therapy

The rheumatologist prescribes medication depending on the general condition of the patient. The clinical picture provides the necessary information for the development of treatment regimens with drugs from several groups.

1. Anesthetics.Broad-spectrum injections, ointments or medications are prescribed.
2. Anti-inflammatory drugs (NSAIDs).
3. Vasodilators.Removal of tone from the muscles of the lumbar region and legs.
4. Chondroprotectors.Designed to rule out the negative progression of lumbar osteochondrosis.

Physiotherapy

Physiotherapy procedures are an integral part of inpatient or outpatient treatment of lumbar osteochondrosis.

Includes the following activities:

• Electrophoresis with painkillers;
• Magnetotherapy;
• Hydrotherapy;
• Paraffin applications.

Medical and physiotherapy in the complex alleviate acute pain and inflammation. But they are not a guarantee of stopping the progression of the pathology. Only treatment 2-3 times a year and a responsible attitude of the patient will help to avoid regression and to keep the general condition in a satisfactory form.

Physical therapy and therapeutic massage

A set of therapeutic gymnastics exercises ensures the normalization of blood circulation in the lower back and helps to eliminate stagnant processes. Only a physiotherapist can prescribe exercises for clinical or home use. As a rule, these are all types of soft inclines and rotational movements, from a lying and sitting position. Not only can physical activity alone bring no results, but it can cause even greater displacement of the vertebral discs.

Manual therapy sessions help strengthen muscle tissue, blood flow to the affected lower back, and relieve tension. The specialist first massages a healthy part of the back, to warm up the muscles and improve blood circulation. It then goes to the affected areas of the lumbar region. The area of manipulation includes the lower back, buttocks, thighs, lower legs and feet. Sessions are held in regular courses, at least 10 sessions in 6 months.

Surgical intervention

It is indicated in the last stage of lumbar osteochondrosis, in order to restore motor function of the spine. Surgery remains the only option for patients who have the following symptoms:

• Persistent pain syndrome, which cannot be treated even with opiate-containing drugs;
• Strong nerve root compression and significant disc displacement;
• Neoplasms, bone proliferation;
• Complete destruction of the vertebrae, due to constant friction;
• Paralysis.

Modern methods offer less traumatic methods of internal intervention. For example, endoscopy. It has a favorable prognosis, a short rehabilitation period and a low rate of side effects.

Alternative treatment

Lumbar osteochondrosis responds well to treatment with herbs and folk methods. Ointments, tinctures, fee-based baths are used to relieve swelling and pain. The most effective recipes include anesthetic and anti-inflammatory herbs:

• yarrow;
• Aloe;
• Peppermint;
• St. John's wort;
• Spruce or pine needles;
• Sage.

The content of these plants in folk recipes is a consequence of their healing effect, scientifically proven by traditional medicine. Treatment at home will help keep the lower back in a stable condition and prevent the disease from getting worse after a complex treatment.

Prevention

Despite the fact that lumbar osteochondrosis is an incurable disease, its negative manifestations can be minimized. In the early stages, the disease is successfully treated, it is only necessary to seek medical help in a timely manner. It is important to fully adhere to the prescribed treatment regimen and follow the recommendations of a rheumatologist.