Osteochondrosis of the lumbar spine

Low back pain in a patient with osteochondrosis of the lumbar spine

One of the most common diseases today isosteochondrosis of the lumbar spine. Men and women often turn to doctors with this disease.

At least once in our life, each of us has felt pain in the lower back, sacrum or lower limbs. We often unknowingly call this type of pain "pinched nerve in the lower back. "

Causes of lumbar osteochondrosis

According to research by doctors and scientists, the main cause of osteochondrosis of the lumbar spine is upright posture. However, not everyone suffers from osteochondrosis. The provoking factors that accelerate the development of the disease are: metabolic disorders, physical inactivity, injuries, excess weight, improper lifting of weights.

The source of pain in osteochondrosis is pinching of the nerve roots, which occurs after protrusion of the intervertebral disc and narrowing of the intervertebral space. This deviation is formed when nutrition deteriorates, the natural processes of oxygen and lymph exchange in the tissues of the intervertebral discs are disrupted. As a result, the shock absorption capacity of the intervertebral discs decreases and the nucleus pulposus of the disc gradually shrinks and dries out.

From an anatomical point of view, lumbar osteochondrosis is a process of transformation of cartilage into bone, leading to excessive pressure on the nerve roots that extend from the spinal cord. This change causes pain. The overgrowth of bone tissue occurs due to deterioration in the nutrition of the intervertebral discs, loss of fluid and disturbances in structure and function.

When the protrusion of the intervertebral disc during the development of osteochondrosis of the lumbar spine becomes more serious, it causes the development of lumbar protrusion and lumbar disc herniation due to rupture of the annulus fibrosus.

The pain syndrome occurs due to pinching of the spinal nerve in lumbar osteochondrosis and is called lumboischialgia. This symptom is accompanied by numbness of the lower limbs. Depending on the nature and localization of pain, the disease can be divided into sciatica and lumbago. Inflammation of a nerve due to pinching is called radiculitis. Methods of treating radiculitis with painkillers, in fact, consist only in eliminating the symptoms and are ineffective, since such treatment does not affect the true cause of the disease, namely the degenerative processes of the intervertebral discs. To eliminate pain and take preventive measures to prevent complications, you need to undergo comprehensive treatment to activate the restoration processes in the disc tissues, normalize the height and physiological parameters of the intervertebral discs.

Symptoms of osteochondrosis of the lumbar spine

Lumbar spine with obvious manifestations of osteochondrosis

One of the signs of osteochondrosis is compression of the spinal nerve roots by the protruding nucleus pulposus of the intervertebral disc. This compression occurs in the epidural space, which is a sort of container for the spinal roots. Osteochondrosis of the lumbar spine manifests itself by the following symptoms which correspond to a compressed root:

  • L1 and L2 – loss of sensitivity in the "rider’s pants", namely in the groin and inner thighs. Pain can occur simultaneously in both legs if lumbar osteochondrosis is complicated by the development of a hernia.
  • L5 – stabbing pain, decreased lower back sensitivity and thumb sensitivity, as well as decreased ability to flex the finger.
  • S1 – shooting pain, decreased sensation in lower leg and outer thigh, pain in foot from little toe to fourth toe. Often when this root is damaged, the Achilles and plantar reflexes are lost.
  • Damage to the Deproge-Gottéron artery - during the chronic course of osteochondrosis, paralysis of the lower leg and buttocks may occur, and sensitivity may disappear in the anogenital region.
  • Simultaneous lesions of the L5, S roots and the Deproge-Gottéron artery cause the syndrome of "paralyzing sciatica", loss of pelvic and motor functions.

Osteochondrosis of the lumbar spine can cause protrusions and hernias due to significant loads on this part of the spine. These are the complications that develop very quickly, so it is very important to treat them quickly. Do not delay your visit to a vertebrologist, undergo a comprehensive examination and seek qualified help at the first symptoms of lumbar osteochondrosis.

Complications of osteochondrosis of the lumbar spine

Vascular ischemia due to compression can be considered a complication of lumbar osteochondrosis. This pathology develops due to impaired blood supply to the spinal cord, a reduction in the intervertebral openings of vessels and arteries, as well as a narrowing of the peripheral structures of the vertebrae. The cause of the development of this pathology is flattening of the discs, excessive mobility of the spine, weakening of ligaments, the formation of osteophytes and neoarthrosis. Permanent injury and pressure on a pinched vessel or artery occurs due to any movement of the spine that affects the damaged area. Additionally, reflex narrowing of the vessel passing through the tight opening of the canal may develop. This effect is called "narrow bed".

Vertebrologists identify another serious complication of osteochondrosis of the lumbar spine. Compressive myelopathy is a disorder of the spinal cord caused by narrowing of the spinal canal. Depending on the location, the symptoms and severity of the pathology can vary. Most often, the course of the disease is characterized by episodicity - after an attack there is a period of remission.

Lumbar osteochondrosis can be complicated by a herniated TXII-L1 disc, which exerts pressure and causes damage to the S1-S2, L2-L-4 segments of the spinal cord. A patient with this complication feels pain in the lower back, lower leg, back of the thigh, as well as weakness in the legs. The gluteal and calf muscles gradually become hypotonic and hypotrophic, the Achilles and plantar reflexes fall, and foot paresis forms. The back and external surfaces of the foot and lower leg are characterized by reduced sensitivity or its complete absence.

If a LI-II disc herniation develops, in which excessive pressure on the S3 coccygeal segment increases, osteochondrosis of the lumbar spine has the following symptoms: disruption of the pelvic organs, fecal and urinary incontinence, constipation, loss or decrease insensitivity of the anogenital area, development of bedsores, anal prolapse reflex.

"Horsetail syndrome" develops when nerve roots are compressed from the first lumbar vertebra and below. An experienced vertebrologist notes that this syndrome most often develops in patients with congenital narrowing of the spinal canal. The "horsetail" is a bundle of nerve roots that contains the terminal roots of the spinal cord from the first segment. The name comes from its resemblance to a ponytail. The diagnosis of this syndrome largely depends on the presence of excruciating pain of a radicular nature. It is this feature that distinguishes cauda equina syndrome from other complications without acute pain.

Cauda equina syndrome is characterized by intense pain in the sacrum and lower back, which radiates to the buttock, anogenital region and posterior thigh. In some cases, paresis, peripheral paralysis and sensory disturbances occur. Severe cases are characterized by paralysis of the buttocks and both legs. A characteristic feature of the complication can be considered the asymmetry of sensory and motor disorders.

Lumbar osteochondrosis can cause the development of myeloid syndrome of "intermittent claudication", characterized by weakness in the legs when walking, frequent urge to urinate and numbness of the lower torso. The cause of this discomfort is poor blood supply to the lower parts of the spinal cord. After rest, these sensations disappear.

With ischemia of the cauda equina roots, caudogenic "intermittent claudication" occurs - goosebumps and tingling sensations when walking. Over time, this symptom can worsen and affect the perineum, genitals and groin. Leg weakness disappears after a short rest.

Compression of the Adamkiewicz artery can occur due to unsuccessful sudden movement, heavy lifting or tremor. This complication of osteochondrosis of the lumbar spine is manifested by disorders of the pelvic organs, loss of sensitivity, the appearance of bedsores and atrophy of the leg muscles.

Osteochondrosis of the lumbar spine is manifested by aching pain in the lower back. Due to prolonged stay in an uncomfortable position, pain may intensify. After sleeping or resting while lying down, the pain decreases or disappears completely.

The occurrence of stressful situations for the body can provoke the development of an acute illness. Most often this happens with hypothermia, heavy loads and sudden movements. An exacerbation is characterized by severe pain, which from the lumbar region can go down to the legs. The body can independently try to reduce the load on the affected part of the spine due to strong tension in the lower back muscles. A patient suffering from osteochondrosis of the lumbar spine tries to find a comfortable position in which the pain subsides.

Diagnosis of lumbar osteochondrosis

The diagnosis of osteochondrosis is carried out in several stages. The doctor must discuss with the patient, inquire about the complaints, find out about the nature of the pain, where it is located, when the painful sensations are felt, their duration, their intensity, etc. In addition, the doctor will know under what conditions the pain appears, when it intensifies or subsides.

After that, the vertebrologist examines the anamnesis, i. e. history of the disease. The doctor will certainly clarify how long the painful condition lasts, what was the cause of the pain and how you feel during the period when the discomfort disappears. An important point is preliminary treatment, as well as the effectiveness of certain treatment methods. A qualified doctor will certainly ask the patient about his living and working conditions, range of motion, well-being under certain loads and previous illnesses. It is very important to know whether the patient has suffered spinal injuries, whether he played sports, and whether any members of his immediate family have suffered from spinal diseases.

The next stage of diagnosis will be examination of the patient. The doctor will pay attention to the position of the head, legs and arms in relation to the body, the gait, the way of standing, the symmetry of the areas of the body, the condition of the skin in the areainjured and to the movements of the patient. After that, the range of motion of the spine and the level of damage are established. To do this, the doctor will ask the patient to lean forward, sideways, backwards, ask them to move different parts of their back and tilt their head. A healthy person should not feel any cracking or pain in their joints during such a simple test.

If the patient does not suffer from osteochondrosis, then he can reach his chest and shoulder with his chin. Head movements in each direction are approximately 60 degrees. A 45-degree angle is formed by leaning sideways between the head and the upper cervical spine. The distance between the sacrum and the spinous process of the seventh cervical vertebra increases by 5 to 7 centimeters when leaning forward. This distance is reduced by 5 to 6 cm by leaning backwards. An experienced vertebrologist will pay attention to how the knee and hip joints participate in flexion and how the configuration of the spine changes.

Treatment of osteochondrosis of the lumbar spine

Lumbar osteochondrosis requires complex, intensive and long-term treatment. This is especially true for chronic cases with multiple hernias and intervertebral protrusions.

Effectivetreatment of osteochondrosis of the lumbar spineis obtained by reflex methods that do not cause side effects, but bring maximum benefit. Remember that recovery from such a serious illness cannot be quick. In each case of lumbar osteochondrosis, the doctor prescribes an individual treatment regimen.

Manual therapy for the treatment of osteochondrosis of the lumbar spine

It should be noted that manual therapy can only be used in cases where the patient's spine is not damaged by protrusions or intervertebral hernias. The integrated use of these techniques allows you to restore normal blood microcirculation, eliminate congestion, vascular edema, relieve muscle spasms, restore the balance of metabolic processes in the tissues of the vertebrae and intervertebral discs, as well as improve the nutrition of the tissues of the lumbar region. The natural regeneration process is thus stimulated. It should be noted that in case of lumbar osteochondrosis, manual therapy should be aimed at improving the functions of the spine.

Procedures for the treatment of lumbar osteochondrosis are complemented by the use of herbal remedies that improve the innervation of the body, and also restore the balance of metabolic processes. The vertebrologist will recommend nutritional correction and a more active lifestyle to patients. It is important to adjust your body weight, because excess weight puts additional pressure on the lower back and also aggravates the development of osteochondrosis of the lumbar spine.

An experienced specialist who treats osteochondrosis allows the patient to achieve serious results, avoid surgical intervention, improve motor activity, eliminate lower back pain and overall improve the body to avoid furtherexacerbations. Acute pain disappears after 1-3 sessions of manual therapy, and the positive effect of treatment is achieved on average after 10-15 sessions. Remember that timely start of treatment is a guarantee of achieving positive results.

During the period of exacerbation of pain in the lower back, the patient is recommended to stay in bed for 2-3 days. To quickly relieve pain, nonsteroidal anti-inflammatory drugs, analgesics, venotonics, diuretics, nicotinic acid and B vitamins are prescribed. Walking with crutches, dry or underwater traction of the spinespinal may also be prescribed to unload the spine. If necessary, blockades with glucocorticoids or paravertebral blocks with an anesthetic are prescribed.

Physiotherapeutic treatment of osteochondrosis of the lumbar spine may also include electrophoresis, laser therapy and ultraviolet radiation. Physiotherapy is a mandatory component of a comprehensive treatment program. Some exercises can be used in the acute stage, but almost all exercises are recommended to be performed after the pain has subsided. Through regular physical exercise, tissue nutrition is restored, blood and lymphatic supply to the intervertebral discs is improved, and flexibility and elasticity of joints and cartilages are gradually restored. Thus, the patient's condition improves and the interval between periods of exacerbation lengthens.

Thermal treatments also have a beneficial effect on health. At climatic stations, iodine-bromine, hydrogen sulfide and radon baths are prescribed.

Surgical treatment methods are used only if the patient's pain cannot be relieved by conservative methods for a long time, with paresis of the muscles of the lower extremities and disruption of the natural processes of urination and defecation. During the operation, the herniated disc is removed and the spinal segment is strengthened.

Prevention of lumbar osteochondrosis

Correct body position during sleep with lumbar osteochondrosis

Prevention of lumbar osteochondrosis involves following simple rules recommended by a vertebrologist. Remember that the development of the disease can only be avoided by strictly following these rules, no matter what:

  • Keep your lower back dry and warm, don't overcool your spine, and avoid drafts.
  • Do not lift heavy objects or carry them long distances.
  • Try not to make sudden movements.
  • Maintain correct posture when working and resting.
  • Change positions as often as possible, trying not to stay in one position for long.
  • Do physiotherapy.
  • Try not to stay in a hunched position for long.
  • When cleaning, use long mops, a broom, and a vacuum cleaner with a long wand so you don't have to bend over.
  • Lift weights correctly: bend over with a straight back, or bend your knees, pick up the bags with a straight back and stand up straight. Keep your hands with the load as close to your body as possible.
  • If you have to bend over to pick something up from the floor, such as under a table or bed, get on your knees and keep your back straight.
  • Distribute the weights equally between both hands.
  • Strengthen your gluteal muscles, stretch your spine, take a walk every day.
  • Balance your diet, enrich your diet with dairy and plant products.
  • Adhere to the drinking regime - 1. 5-2 liters of water and herbal teas per day.
  • Get rid of bad habits - alcohol, tobacco, drugs.