Pain in the back or waist is the most frequent complaint of patients in general medical practice.They occupy the second place (after respiratory diseases) according to the frequency of requesting medical care. There are a large number of diseases that lead to the onset of pain. But the most frequent cause is osteochondrosis of the lumbar region, the symptoms and treatment of which we will consider in this material.
More recently, medicine believed this state of age-related changes in the spine, which associated with the processes of natural aging of the human body.
Today, lumbar osteochondrosis is considered a rather serious disease that occurs in people of all age groups. Currently, the incidence has a strong tendency to rejuvenate, more and more often the disease is diagnosed in people under the age of 30 years.
The cause of lumbar osteochondrosis has not been established to date. But when faced with this pathology, it is often possible to assume who is more inclined to the disease, is at risk.
- Passive way of life. This includes people who lead a predominantly sedentary lifestyle. In the sitting position, the muscles of the corset relax, which increases the load on the lumbar spine.
- Hormonal disordersmetabolism and endocrine diseases can adversely affect metabolism in the tissues of the spinal column and contribute to the development of osteochondrosis.
- Variouscongenital and acquired abnormalitiesin the structure of the musculoskeletal system - curvature of the legs and spine, flat feet.
- Availabilityconstant large physical exertion on the spine, in particular the lifting of heavy objects. In this case, we can talk about occupational diseases of such categories as athletes, weightlifters and people whose professional duties are associated with the constant lifting of heavy objects.
- Permanentmalnutrition and day regimen, regular stresses, insufficient sleep time, disturbance of metabolic processes.
The points listed above are the most frequent factors that create the prerequisites for the development of the disease.
Degrees of lumbar osteochondrosis
Manifestations of the disease depend on the degree of development of pathology. There are four degrees of osteochondrosis:
- The period of change and movement of the gelatinous core inside the disk. There are pains due to irritation of nerve endings, located in the fibrous ring and longitudinal ligaments. The patient feels local discomfort in that part of the spine where the affected disc is located: acute pain or lumbago lumbago, dull pain of a permanent nature (lumbalgia).
- The period of destruction of the fibrous ring of the disc. Characterized by the emergence of instability and increased mobility of the vertebrae, which causes a prolonged and persistent muscle strain. The patient feels such symptoms as constant fatigue of the muscles of the waist, discomfort,
- The period of ruptures of the fibrous ring and the release of the gelatinous nucleus beyond its limits with the formation of disc herniation. There are so-called radicular syndromes, which are associated with the compression of the nerve roots with fallen fragments.
- Vertebral column strongly deformed. The motor function of a person is difficult. The main issue that needs to be addressed is the patient's disability. However, it must be emphasized that at this stage of the disease the pain is practically absent. But this is not a signal about the suspension of the disease, quite the contrary.
- There is a pathological proliferation of bone tissue, which will further worsen the condition.
How to treat osteochondrosis of the lumbar region will directly depend on the extent of the lesion, using medicamentous, non-medicamentous and surgical methods of influence.
Symptoms of lumbar osteochondrosis
When an osteochondrosis occurs in the lumbar spine, the main symptom is pain. The nature of pain, the place of origin and the direction of propagation depend on which receptors get irritated, that is, how much gross changes in the disc and surrounding tissues, there is protrusion or already a hernia, in which direction protrusion is formed and so on.
Let's list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, aching nature, intensify with sudden movements, changing the position of the body, prolonged stay in one position. Reducing pain occurs when taking a horizontal position;
- Along with pain in the lumbar region, osteochondrosis can give a feeling of weakness in the lower part of the trunk and legs, as well as loss of tendon reflexes of the lower extremities;
- Often there is a curvature of the lumbar spine. Depending on the place where the curvature is observed, we distinguish scoliosis (curvature of the spine to the right or left), lordosis (bend forward) and kyphosis (smoothing of the lumbar flexure);
- In the event that osteochondrosis led to clamping and spinal cord dysfunction, the patient may have uncontrolled urine and stool.
- coldness of the skin and numbness in the lumbar region, buttocks;
- dryness, peeling, blue skin on the waist and buttocks;
- violation of sweating in the buttocks;
- violation of urination;
- erectile disfunction.
This symptomatology indicates the onset of the disease and requires medical intervention. Treatment of osteochondrosis can be carried out in stationary and home conditions.
Diagnosis of osteochondrosis involves the use of various methods, first of all, palpation of the lumbar spine. To confirm the diagnosis, the patient is sent for examination using diagnostic equipment.
- Radiographyhelps to assess the condition of the vertebral column and each vertebra separately. Mediator is also judged on the integrity of the intervertebral disc and spinal canal.
- Whentomographydetermine the degree of damage to nerve endings and the spinal cord. And also assess the condition of intervertebral discs.
- MRI- used to make the final diagnosis.
Correct diagnosis will help to understand, than to treat lumbar osteochondrosis, and what preparations and procedures for this will be required.
Osteochondrosis of the lumbar spine can cause protrusions and hernias due to significant loads on this part of the spine. It is these complications that develop very quickly, so treating them in a timely manner is very important.
In addition, osteochondrosis can be complicated:
- an inflammation of the sciatic nerve;
- hernia of Schmorl;
- osteophytosis, spondylosis;
- stenosis of the spinal canal with compression and impaired spinal cord activity;
- compression of the "horse tail" with a breakdown in the functioning of the pelvic organs;
- paresis of the lower extremities.
To prevent the progression of complications is possible with timely diagnosis and comprehensive treatment.
Treatment of osteochondrosis of the lumbar spine
When lumbar osteochondrosis is diagnosed, treatment requires extensive complex therapy, which implies:
- moderate physical activity;
- use of medicines;
- traction of the spine;
- manual therapy;
Scheme of treatment of osteochondrosis is directed to:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral spine;
- strengthening the muscles in the lower back, buttocks, legs;
- elimination of pathological muscle tension;
- improving the functioning of the pelvic organs;
- regulation of blood circulation and metabolic processes in the affected area;
- restoration of the normal volume of movements in the lower back and an increase in the sensitivity of the lower limbs.
Only a few cases are resorted to surgical intervention.
Such treatment of the osteochondrosis of the lumbar spine includes the administration of tableted, injectable and external (ointments and gels) medications. Drugs used to combat this disease, relieve pain and stop inflammation.
Depending on the manifestations, the doctor may prescribe different pills for osteochondrosis of the waist:
- analgesics (analgesics);
- non-steroidal anti-inflammatory drugs (tilfen, diclofenac, etc.);
- muscle relaxants, to relieve muscle spasm, which occurs due to pain;
- chondroprotectors, restoring cartilaginous tissue (chondroxide);
- corticosteroids (prescribe if all other types of treatment have not helped);
- vitamin preparations.
Very often, in the treatment of osteochondrosis, pills are prescribed that calm the nervous system, as well as antidepressants that combat stressful situations and depression.
Physiotherapy with lumbar osteochondrosis
As a rule, for the treatment of osteochondrosis, some medicines are not enough. To eliminate pain, relieve muscle spasm, stimulate exchange-recovery processes, physiotherapeutic procedures are used:
- diadynamic currents;
- magnetic resonance therapy;
- laser therapy.
Massage is prescribed when the main pain symptom is removed or during the period of remission with chronic pathology. It serves to relax the tense musculature. Very often it is combined with warming up procedures or visiting the sauna. This will help to strengthen the relaxing effect on muscle tissue and stimulate blood circulation.
Manual therapy, which is conducted only by a specialist in this field of treatment, strengthens the blood circulation of the spinal cord, puts in place displaced discs of the spinal column.
The whole complex of physical exercises used in diagnosing lumbar osteochondrosis should promote the mobility of the lumbar spine.
Therapeutic exercises will not be effective if the exercises are carried out from case to case. The main principle of exercise therapy is regularity. Constant performance of a certain set of exercises will help to eliminate destructive processes in intervertebral joints.
Usually, the doctor prescribes surgery only in the case when serious complications develop. For example, intervertebral hernia. The most common type of surgical intervention is the removal of a damaged disc (discectomy).
This operation is considered the most productive method in this case, but at the same time is appointed only if other methods of treatment do not bring results within six months. In addition, the method of microsurgical and endoscopic treatment of the spine is common.
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