1Spondylarthrosis of the lumbosacral spine: symptoms and treatment
- 1.1Anatomy of vertebral joints
2Symptoms and treatment of spondylarthrosis of the lumbosacral spine
- 2.1The essence of spondylarthrosis: what happens when a disease occurs?
- 2.2Causes of lumbar and sacral spondylarthrosis
- 2.4Methods of treatment
- 2.51. Medicines
- 2.6Non-steroidal anti-inflammatory drugs (NSAIDs)
- 2.7Muscle relaxants
- 2.8Novocaine blockades
- 2.10Other drugs
- 2.112. Physiotherapy
- 2.123. Possible operation
3Symptoms, pathogenesis and treatment of spondylarthrosis of the lumbar spine
- 3.1What is spondyloarthrosis?
- 3.2Lumbar degenerative-dystrophic arthrosis: causes
- 3.3Lumbosacral spondylosis - what is manifested
- 3.4Lumbar osteochondrosis: the main symptoms
- 3.5Types of pain in spinal cord spondylarthrosis
- 3.6Basic principles of spinal spondylarthrosis treatment
- 3.7Spondylarthrosis of the lumbosacral spine: medication
- 3.8Spondylarthrosis of the lumbosacral spine: what to treat
4Spondylarthrosis of the lumbar spine - what is it, signs and symptoms, treatment and exercise therapy
- 4.1What is spondylarthrosis of the lumbar spine
- 4.3Treatment of spondylarthrosis of the lumbosacral spine
- 4.4Exercise therapy
- 4.5Local drug therapy
5Signs of spondylosis of the lumbosacral spine
- 5.1Etiology of the phenomenon
- 5.2Symptoms of spondylosis
- 5.3Diagnostic measures
- 5.4Principles of treatment
- 5.5Preventive actions
Spondylarthrosis of the lumbosacral spine: symptoms and treatment
In medicine, arthrosis is considered a disease that plagues the human body as a natural aging companion.
Degenerative changes in articular cartilage and bone tissue occur for so many reasons that Spondylarthrosis of the lumbosacral spine is considered to be as common a disease as ARI.
The disease affects the facet joints, formed by articular processes on the vertebrae. The article considers the most common type of spondyloarthrosis, its causes, diagnosis, symptoms and treatment with classical and folk methods.
Anatomy of vertebral joints
The lumbar region is composed of the 5 largest and strongest vertebrae in the entire vertebral column.
The daily vertical load of half the human body made the vertebrae thick-walled, squat, with powerful articular and transverse processes.
Each vertebra is provided with two pairs of processes located on the arc. Upper and lower "facets" (dr. the name of these bony outgrowths) form the facet joints.
Anatomically the joints are "diartroznye that is partially mobile: enveloping capsule allows to stretch the joint in a vertical direction (with tilts forward) with lateral rotations the spine. Periarticular bags are innervated by sensitive endings that report the degree of pressure.
The surface of the joints is covered with hyaline cartilage.
Hyaline is less durable than the fibrous cartilaginous tissue of the fibrous rings of the intervertebral discs, but is restored more quickly.
Abundant "lubrication" in the form of synovial fluid improves the mutual sliding of the joint articular processes inside the capsule enveloping the joint.
The bending of the lumbar lordosis redistributes the vertical pressure on the facet joints (especially when flexing backwards). That is why, in the lower back and its connection with the sacrum, articular processes are short and powerful, with wide pits.
Between joints of joints and vertebral bodies there are holes formed by arcuate incisions on the legs of the processes. Through these natural passages, spinal nerves and blood vessels are brought to the spinal cord.
Each segment of the spinal cord is connected through the nerve with a specific area of the body. The nerves of the lumbar spine connect the organs of the digestive tract and the genitourinary system, the muscles of the lower extremities, to the spinal cord.
The sacral section of the spine is composed of 5 intergrown vertebrae. The pyramidal structure is firmly connected with the pelvic bones in a single belt.
The upper area of the first sacral vertebra and articular processes form a solid triangular base for supporting the entire vertebral column.
The area of the articular pits is increased in comparison with others located in the overlying joints. The intervertebral disc of the L5-S1 joint has a wedge shape.
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The disease is a natural companion of another degradation process - chondrosis (or osteochondrosis) of intervertebral discs.
The decrease in the height of the basic vertebral "shock absorbers" transfers a significant part of the vertical loads to the less durable hyaline cartilage of the facet joints.
For information: in a normal intervertebral joint, the load is distributed in a proportion of 80-85% per disc and 15-20% per joint. The development of osteochondrosis to the third degree (the appearance of protrusions and hernias) carries up to 70% of the vertical load on the joints.
The collapsing collagen that does not have time to recover is thinned to the bone tissue. Primary disorders of hyaline cartilage integrity cause a protective reaction: the formation of an additional synovial fluid.
Irritated by frequent contact, the outer bone layers begin to produce an excessive dense tissue, which is manifested in the appearance of osteophytes (spike-shaped outgrowths). As a result of irregular growth of the head, the articular processes become pear-shaped.
With limited mobility of the joint, the tissues of neighboring processes can grow together into a single monolith.
Lesions of the facet joints have a pronounced symptomatology: the nerve endings in the joint capsules are signaled with acute pains about the damage to the hyaline coating and bone tissue. The pain signal can be non-localized, scattered to adjacent vertebrae.
Sharp pain caused by spondylarthrosis, was called "facet syndrome" in medicine. Under this name, other signs of joint damage are combined: subluxations, synovitis (inflammation of the periarticular bag with an increase in synovial fluid).
Reducing the height of the joints causes another, even more serious syndrome - radicular. Passing to the spinal cord, the spinal nerves are divided around the vertebral body into the upper and lower roots.
Solid arches of reduced foraminal holes fall on the roots and block the passage of nerve impulses. Irritated by touching the myelin sheaths of nerve "conductors" become inflamed and increase in volume.
The nearby blood vessels are also pinched and spasmodic.
Partially blocked blood circulation is not able to provide full nutrition with oxygen and substances necessary to replenish the hyaline tissue of the intervertebral disc and periarticular capsules.
The painful sensations accompanying the blockage of the spinal roots differ from the acute pain of the facet syndrome, with less intensity.
Stupid "lumbalgic" pain in the spinal column is supplemented by sensations of a different nature: "goose bumps" tingling and temporary numbness in the musculature associated with a particular segment of the spinal cord through the upper roots of the nerve.
Blocking the lower roots causes weakness and retardation of the reaction to irritation, with the increase in the blockade growing into paralysis of the musculature.
The same situation with regard to communication with the internal organs of the abdominal region and pelvis is expressed in spasms and pains, disruption of functioning.
The increase and asymmetry of developing buildups on the joints can lead to displacement of the vertebrae (spondylolisthesis).
The prolapse of the vertebra changes the shape and volume of the spinal canal, which can lead to compression of the spinal cord.
The result of this blockade are dysfunction and paralysis of the pelvic organs and leg musculature.
Since spondyloarthrosis accompanies osteochondrosis, symptomatic pains often mingle and seem to be signs of more extensive lesions. But the painful sensations in the joints are more acute and localized.
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Painful sensations when touching indicate the exact location, and more careful palpation shows the size of the lesion. But more accurate information is provided by the visualization of the joints and the spine, which can be obtained with the help of radiography, computed tomography and MRI.
X-ray images give an accurate picture of the changes in bone tissue of articular processes: an increase in the heads, an increase in osteophytes. Computer tomography gives the same result, but more detailed and qualitative. CT imaging allows you to see a three-dimensional picture of the changes.
Magnetic resonance imaging will best show the condition of the periarticular capsule, hyaline cartilage on the heads of the appendages and other soft tissues surrounding the joints.
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Doctors-orthopedists recommend the initial stages of osteochondrosis and spondyloarthrosis, combined in time, treated in a comprehensive manner. Conservative methods of treatment include the use of medicines, physiotherapy and physiotherapy.
For the treatment of degrading cartilaginous tissues, bioactive agents "chondroprotectors" are used.
They include activators of the reproduction of cells containing collagen, and accelerators of natural synthesis of hyaluronic acid. This substance retains water in the collagen fibers at the molecular level.
The use of chondroprotectors slows down the "aging" of the cartilaginous fibers and increases the growth of the tissues of the periarticular capsule.
Pain syndrome, accompanying the disease of the back, is removed with the help of two types of medications:
- nonsteroidal anti-inflammatory drugs. Have a complex effect: reduce the inflammatory process in compression-deformed tissues (membranes of nerve roots, vessels), relieve puffiness, reduce painful sensations;
- analgesics. Used in more serious cases (regular "lumbago" ie "lumbago"). Intramuscular injections around the localization of pain completely "turn off" all sensations for the duration of the blockade.
To improve the effectiveness of non-steroid drugs, medications with a relaxing effect are recommended - muscle relaxants.
Under the action of these drugs, spasmodic deep muscles, connecting the transverse processes of the vertebrae, relax, which facilitates the release of blocked nerve roots.
Physiotherapy is aimed at stopping pain and relaxing the muscles.
Electrophoresis helps drugs better penetrate into areas affected by spondylarthrosis.
Magnetic and laser therapy reduce the sensitivity of nerve endings in the periarticular capsules, relieve spasms of the vessels and small muscles of the back.
Therapeutic exercise in the treatment of spondylarthrosis is aimed at increasing the elasticity of the intervertebral discs and joints.
Developed by stretching exercises, fibrous rings and hyaline plates (surface coatings of the vertebrae and joints) are better restored.
Improves blood circulation of the joints and the near-vertebral tissues (muscles and ligaments).
shows the correct exercises for acute pain in the lumbosacral department:
An orthopedic doctor may prescribe wearing a corset supporting the lumbar region for the period of active treatment. The design takes on a part of the load, reducing the mobility of the affected vertebrae and joints.
In cases where joint pain becomes unbearable, it is recommended that surgical methods be used to block the innervation of the facet joints. The system of nerve endings in the joints is blocked by means of electromagnetic pulses of a certain frequency.
The effect is made under conditions close to the sterile (in the operating room), but in 80% of cases it does not require skin damage and insertion into the periarticular region.
The procedure lasts 30 minutes, after which the patient ceases to feel pain in the cervical joints.
Another, no less effective way of blocking nerve impulses is to "cauterize" nerve fibers with a high-frequency pulse of electric current. The destructive effect on the nerves is carried out under visual observation.
X-ray low-energy installation provides a high-quality image in the field of operation. Nerves, affected by a current and a temperature of about 70 degrees, completely lose sensitivity.
Often this operation is combined with others aimed at correcting the spinal column: fixation displaced vertebrae, laminectomy (removal of the vertebral arch to release the spinal cord from "Clamping").
In exceptional cases, the articular processes completely destroyed by the degradation process are removed, and the vertebrae are fixed with titanium structures.
A source: http://1pozvonochnik.ru/spondiloartroz-poyasnichno-krestcovogo-otdela/
Symptoms and treatment of spondylarthrosis of the lumbosacral spine
Spondylarthrosis of the lumbosacral spine is a disease of the musculoskeletal system, in which intervertebral joints in the sacrum and lower back are destroyed. Spondylarthrosis affects small facet joints between vertebrae and is the second name facet arthropathy.
In 70% of cases, pathology develops in elderly people due to age-related changes in the body.
In recent decades, the disease is found in young able-bodied patients, which is due to the peculiarities of the modern way of life, low physical activity, irrational nutrition.
Initial manifestations of the disease - periodic pain and decreased mobility of the back in the lumbosacral area.
Progression of the disease leads to increased pain, perhaps even the emergence of complete immobility of the lumbar spine - all this significantly worsens the quality of life and work capacity.
Of the good news: timely diagnosis of the disease and the treatment prevents the development of disability and increases the chances of recovery.
Further in the article, we will talk about the causes of spondyloarthrosis, developmental peculiarities, symptoms and methods of treatment. This knowledge will help prevent the appearance of the disease, notice the first symptoms and promptly consult a doctor (therapist, neurologist).
The essence of spondylarthrosis: what happens when a disease occurs?
The vertebral column consists of vertebrae, which have arches and processes. Between them are located small, so-called facet joints.
These joints have a flat shape, articular bone surfaces are covered with a thin layer of hyaline cartilage and are limited by an articular bag.
Between the bodies of the vertebrae are intervertebral discs - the formation of cartilaginous tissue, performing a cushioning function during movement. The anatomical structure and functioning of the discs is closely related to the work of small joints between the processes of the vertebrae.
The influence of unfavorable factors causes destruction of the cartilaginous layer of the facet joints, narrowing of the joint gap, increased pressure of the overlying vertebra on the underlying one.
This leads to inflammation of the joint cavity and surrounding tissues - muscles, ligaments, vessels of the nerves.
A prolonged course of spondylarthrosis and failure of complex treatment forms bone growth along the edges of the vertebral bodies (osteophytes).
Small protuberances on the processes of the spine are osteophytes
Osteophytes injure surrounding soft tissues, cause reflex spasm of muscles, infringe nerve roots, that manifested by pain in the affected area and impaired motor activity of the lumbosacral department the spine. In the advanced stages of spondyloarthrosis, deforming spondylosis develops-fusion of osteophytes with each other and blockage of the motor segment of the vertebrae.
Causes of lumbar and sacral spondylarthrosis
The causes of spondylarthrosis of the lumbosacral and other parts of the spine are the same.
In elderly patients, spondyloarthrosis is often diagnosed without identifying predisposing diseases, which is explained by the natural aging of the body.
In young people aged 20-40 years, spondylarthrosis develops due to the influence of unfavorable factors. It:
- dorsopathy (diseases of the spine, associated with the destruction of bones and joints);
- back injury;
- flat feet;
- violation of posture, scoliosis, pathological kyphosis;
- heavy physical work with axial loads on the vertebral column (lifting and bearing weights);
- hypodynamia, sedentary work;
- professional sports;
- endocrine diseases (obesity, diabetes mellitus);
- congenital anomalies in the development of the spine.
Usually spondyloarthrosis develops against the background of osteochondrosis - a disease that is accompanied by the destruction of intervertebral discs and the formation of hernial protrusions.
The preferred localization of osteochondrosis is the lumbosacral spine, so spondyloarthrosis is more common in this area than in other parts of the back.
Absence of necessary treatment and regular medical supervision usually leads to the defeat of small joints between the processes of the vertebrae.
Spondylarthrosis of the lumbosacral spine is characterized by a slow progressive course.
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Methods of treatment
Spondyloarthrosis is treated by: therapist, neurologist, traumatologist - depending on the cause of the disease. Start therapy with conservative methods. The principles of therapy of spondylarthrosis in the lumbosacral and other parts of the spine are very similar.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs reduce the intensity of inflammation, eliminate pain, have an antipyretic effect.
Celecoxib, movalis, nimesulide are modern selective NSAIDs that do not damage the gastric mucosa.
Diclofenac, indomethacin, ibuprofen are non-selective drugs, they require an additional intake of nolpase or omez to protect the digestive tract.
Possible side effects of the drug "Movalis and how often they are driving
Miorelaxants with a central mechanism of action are used to relax the pathological spasm of muscles in the joint lesion site. This improves blood flow and reduces pain.
Assign baclosan, sirdolud, midokalm.
In the case of intense pains that usually appear when you are involved in the inflammatory process of the nervous rootlets, conduct novocain blockades, which are most effective in the pathological process in the field loins. To increase the effectiveness and duration of the procedure, glucocorticoids are added to novocaine.
This treatment is prescribed for the purpose of rapid relief of pain syndrome.
For the normalization of metabolic processes in the cartilaginous tissue and prevention of its further destruction, drugs from the group of chondroprotectors are used: don, gialgan, aflutop, terraflex. These medicines contain important components of articular cartilage: chondroitin sulfate and glucosamine.
Treatment with chondroprotectors is long, the course lasts from 3 months to 6 months. It is recommended to repeat the courses.
To improve blood flow in the area of pathology and normalize metabolic processes, recommend trental, pentoxifylline, ascorbic acid (vitamin C), tocopherol acetate (vitamin E), countercranial. For the regeneration of damaged nerves and restoration of conduction of nerve impulses complex preparations of group B are used - neuromultivitis, neurovitamin, milgamma.
Outside the period of exacerbation of the disease, physiotherapy procedures are used to treat:
- electrophoresis with lidase, magnetotherapy, phonophoresis with hydrocortisone;
- massage for relaxation of muscles, activation of blood flow, normalization of metabolism in the area of pathology;
- an individual exercise program for strengthening the spine and back muscles.
3. Possible operation
If the conservative treatment of spondylarthrosis, the growth of large osteophytes, painful syndrome - carry out operations to remove bone outgrowths followed by plastic surgery the spine.
A source: http://SustavZdorov.ru/artroz/spondiloartroz-poyasnichno-krestcovogo-otdela-pozvonochnika.html
Symptoms, pathogenesis and treatment of spondylarthrosis of the lumbar spine
When changes are not formed clinical symptoms, which does not allow to identify the disease in the early stages.
After a while after degeneration, synovitis develops - inflammation of the periarticular tissues, ligaments, tendons of muscles.
Modern approaches to the treatment of lumbar osteoarthrosis are based on the restoration of cartilage. By using local forms of chondroprotectors, it is possible to achieve local maintenance of the integrity of intervertebral discs.
An example is a chondroxide ointment. Its use is popular with neurodystrophic lumbargia, lumbar arthrosis.
The expediency of using chondroitin sulfates together with anti-inflammatory agents is discussed by scientists.
The latter drugs have a negative effect on the gastrointestinal tract, provoke stomach ulcer. Their use is possible not more than 10 days. There are no other more effective drugs.
Describing the disease, we will pay attention to the pathogenetic links of the pathology. Nosology is observed in women after 55 years, men - after 45 years.
The prevalence of diseases of the lumbar spine in elderly patients is explained by a violation blood supply to the spine, lack of nutrients, dystrophic disorders.
World statistics indicate a gradual increase in spondyloarthrosis in young people. The cause of the condition is a sedentary lifestyle, eating foods saturated with flavors, preservatives, biologically active additives.
What is spondyloarthrosis?
Spondylarthrosis of the lumbosacral spine is the most common pathology of the spine. The condition arises because of the increased stress on the lower parts of the spine during walking, lifting weights. For arthrosis of intervertebral joints, the following symptoms are typical:
- Cervical pain;
- Periodic tingling with compression of the spinal nerves;
- Radiography shows arthrosis of the arched joints;
- Lumbalia (lower back pain) - every third patient;
- Disturbance of skin sensitivity.
To treat the disease, non-steroidal anti-inflammatory drugs are prescribed. With their help it is possible not only to eliminate inflammatory changes, but also to reduce the pain syndrome.
Lumbar degenerative-dystrophic arthrosis: causes
Causes of spondylarthrosis:
- Diseases of the reproductive system;
- Old age;
- Household harmfulness;
- Disorders of posture.
Common spondylarthrosis is caused by genetic factors, occupational hazards, secondary diseases.
The following forms of nosology are distinguished according to the etiological factor:
Primary spondylarthrosis is characterized by lesions of intervertebral joints, the formation of nodules Bouchard, Geberden along the ligaments of the spinal column in the lumbar and cervical spine.
In the prevalence of nosology, the following forms are distinguished:
The local form is accompanied by inflammatory changes in certain parts of the spinal column (lumbar, sacral, cervical, thoracic). The generalized course is characterized by the lesion of more than one vertebral column.
Secondary spondylarthrosis of the lumbar region is accompanied by degenerative-dystrophic changes of organs against a background of other diseases:
- Dysplasia of the musculoskeletal system;
- Aseptic necrosis;
- Infectious arthritis.
The narrowing of the gaps of the articular joints, the marginal bony growths lead to a decrease in the endurance of the affected vertebral column.
When lifting weights, walking creates an increased load on the spinal axis.
Weak segment is prone to traumatization, cracking of the intervertebral disc.
Additional traumatization of cartilaginous tissue is also caused by the influence of acquired and congenital factors. With nosology, pronounced morphological changes in the cartilaginous matrix of the intervertebral disc are observed.
Erosive changes in cartilaginous tissue lead to the destruction of collagen fibers of type 2 (with the degradation of proteoglycan molecules). Protein-polysaccharide complexes respond to the stability of smooth muscles.
In spondyloarthrosis, there is an increased synthesis of stromelysin, collagenase - enzymes that destroy the collagen network, proteoglycans.
This pathogenetic mechanism is caused by genetic factors.
The release of substances by the synovial membrane is accompanied by degradation of the cartilaginous matrix.
Metalloproteases are issued in the form of proenzymes, which are activated by the action of proteases. The activating factor is plasmin. When the cartilage tissue is damaged, the concentration of the plasminogen activator increases.
The disintegration of collagen and proteoglycans is accompanied by an increase in inflammation. At the same time, an autoimmune response is stimulated, characterized by the formation of antibodies against the body's own tissues.
Inflammatory articular changes are accompanied by an increase in the level of cytokines that stimulate the penetration of inflammatory factors.
Elimination of the above-described factors can reduce soreness, reduce inflammation, and prevent microcirculation disorders.
Morphologically, with spondyloarthrosis, there is a modernization of the cartilage - from durable and smooth it turns into a dull, rough version.
The early stage of nosology is accompanied by the formation of individual softening sites (fragmentation) with the appearance of individual vertical cracks in the cartilage.
The use of chondroprotectors can prevent further thinning of the tissue.
Lumbosacral spondylosis - what is manifested
Symptoms of lumbosacral spondylosis according to the working classification:
Reflex symptoms include lumbichalgia, lumbulgia, lumbago. Lumbichalgia is accompanied by a painful lumbar syndrome that spreads to one or two limbs. Pathology is combined with muscle-tonic, neurotrophic, vegetative-vascular disorders.
Lumbalia is a chronic or subacute pain that occurs after physical exertion, gradually. The constant progression of pain appears after a long standing position, taking an uncomfortable position.
Lumbago occurs after lifting weights, sudden movement, coughing. The pain syndrome is strong in pathology. It is formed by the type of lumbago, radiculitis (inflammation of the spinal roots).
Radicular symptoms are accompanied by radiculitis. Spondylarthrosis, osteochondrosis, herniation of the intervertebral disc - frequent causes of the disease. Compression of the spinal nerves is observed at the level of the first sacral or fifth lumbar vertebra.
The root-vascular changes are characterized by radiculo-ischemia, infringement of the radicular artery, veins.
Radiculitis is accompanied by sensory or motor impairment of the lower extremities. Clinical symptoms of the disease are formed according to the level of nerve impairment.
Radiculo-ischemia is characterized by infringement of radicular-spinal vessels. Clinical symptoms of the pathology are accompanied by paralysis or paresis of the lower extremities.
Lumbar osteochondrosis: the main symptoms
Degenerative-dystrophic osteochondrosis is accompanied by the following clinical manifestations:
- Stiffness of the spinal column;
- Deformation of the lesion;
- Pain sensations of the lower back;
- Micro fractures of the subchondral bone;
- Osteophytes of the periosteum;
- Inflammation of peripheral tissues;
- Sprain of the joint capsule;
- Narrowing of the periarticular muscles;
- Inflammatory process of the synovium.
Types of pain in spinal cord spondylarthrosis
There are 4 types of pain in spine spondylarthrosis:
- Dull night pains with venous stasis, increased intraosseous pressure;
- Mechanical pain syndrome with strong physical exertion, increase in depreciation properties;
- Spasm of the invertebral muscles;
- "Start" short-term pain after rest, increased motor activity, friction of joint surfaces, destruction of bones.
When synovitis severe joint pains are formed, stiffness occurs in the morning, a local increase in temperature, swelling. With the active course of the disease, synovitis symptoms become more frequent.
With the passage of time, fibro-sclerotic changes develop, joint stiffness.
Gradually develop degenerative-dystrophic changes with concomitant intraarticular changes:
- Narrowing of intervertebral fissures;
- Formation of marginal osteophytes;
- Subchondral osteosclerosis of articular surfaces.
In pathology, optional x-ray symptoms can be observed:
- Calcification of cartilaginous tissue;
- Subchondral cysts;
- Bone fracture of the bone.
Spondylarthrosis is a disease in which changes in intervertebral joints develop.
Clinical studies have shown a gradual progression of the pathological process in the disease without adequate treatment.
Spondyloarthrosis develops in the elderly. Arthrosis of the facet joints is accompanied by bilateral pain, discogenic radiculitis, stiffness of the vertebral joints.
The spine column physiologically performs the 2 main tasks: flexibility, rigidity. Diametrically opposite goals require optimal operation of all links of the vertebral segment. With defects of at least one link, the functioning of the spine is impaired.
Basic principles of spinal spondylarthrosis treatment
Principles of Spinal Spondylarthrosis Treatment:
- Pharmacological (non-steroidal anti-inflammatory, paracetamol);
- Nepharmacological (exercises, trainings);
- Invasive (intraarticular injections, arthroplasty, lavage);
- Reduction of pain intensity;
- Improved mobility of the joint;
- Slowing down the severity of the disease.
Spondylarthrosis of the lumbosacral spine: medication
Spondylarthrosis of the lumbosacral spine is treated with medications. Conservative therapy is carried out for a long time. It is not possible to eliminate the cause of the disease with conservative methods, therefore, symptomatic therapy is performed.
Preparations against arthrosis of the arcuate joints of the spine:
- Paracetamol is an analgesic, anti-inflammatory drug. It is used at home, but does not provide a pronounced effect;
- Diclofenac is a compound of arylacetic acid, which is released when combined with potassium, sodium. The negative effect of the drug on the gastrointestinal tract makes it impossible to use the product for a long time. The negative effect of diclofenac on the metabolic changes of articular cartilage does not allow using it as an option;
- Rectal gel, suppositories - a local drug. Diklovite suppresses proliferation, exudation, synthesis of prostaglandins. The drug is prescribed for chronic dorsalgia;
- Symptoms of slow action (chondroitin sulfate, diacerin, glucosamine sulfate) are prescribed for a period of at least 3 months;
- Chondroxide, dimethylsulfoxide - medicines with analgesic, anti-inflammatory, fibrinolytic effect.
The disease is treated according to the principles of evidence-based medicine. Because of the side effect of all drugs used in degenerative-dystrophic diseases, the drug should be used according to the principles of evidence-based medicine.
Spondylarthrosis of the lumbosacral spine: what to treat
The spondylosis of the lumbosacral spine should be treated according to the following principles:
- Cerebrospinal blockade with lumbago;
- Muscle relaxants of central action;
- Analgesics, non-steroidal anti-inflammatory drugs;
- Chondroprotectors to prevent the destruction of cartilage;
- Physiotherapy (magnetotherapy, electrocution, ino-galvanization);
- Massage procedures;
- Electrophoresis of chondroxide.
Supportive treatment with folk remedies can prevent repeated attacks of pain, inflammation, and limb sensitivity.
A source: http://vnormu.ru/spondiloartroz-poyasnicy-simptomy-lechenie.html
Spondylarthrosis of the lumbar spine - what is it, signs and symptoms, treatment and exercise therapy
Under the influence of static and dynamic loads, the musculoskeletal system suffers.
Among the potential complications, physicians distinguish such an unpleasant disease as spondylarthrosis of the lumbar spine spine - what it is, and why the patient has pain in the joints, the doctor in diagnostics.
What is spondylarthrosis of the lumbar spine
The disease is accompanied by degenerative changes in the joints of the spine, as a result of which the structural discs become thinner, the hyaline cartilage loses its elasticity, and the marginal bone growths appear.
If such a deformation occurs, inflammation of the soft tissues, acute pain syndrome is observed. Severe pain alternates with muscle spasms, and in the stage of relapse they turn a person into an invalid.
At the next attack it is necessary to call the doctor, that by means of diagnostics to define degenerate changes of a vertebral column.
Spondylarthrosis of the lumbar spine is a chronic disease, the existence of which the patient can guess from the severe pain in the back, amplified in a sitting position. Pathology grows younger every year, and at risk patients of age category of 30-45 years have come on the background of a sedentary lifestyle, low physical activity.
For a long time the disease does not manifest itself in any way, only minor pains in the back of a temporary nature lead to thoughts about the course of the pathological process.
Over time, as the provoking factor effects, the general condition of the clinical patient is only is aggravated, and mild discomfort is replaced by acute bouts of pain, which are paralyzed, chained to bed.
Pain is not the only symptom of spondylarthrosis, attention is also required to other signs of lumbar spine disease:
- the spread of painful sensations to the area of the buttocks, lower limbs;
- stiffness of movements, especially after a morning awakening;
- painful lumbago lumbar region;
- limited mobility of vertebrae;
- strain of the sacral spine;
- decreased physical activity;
- sensation of a feeling of heaviness of the back, lumbar region;
- general weakness, decline in efficiency.
Spondyloarthrosis of the arcuate joints is an acquired disease that occurs against the background of progressive anomalies of the spinal column.
Characteristic deformations with age are the norm, but when they develop rapidly in the intervertebral space, there is an acute pathological process.
The main causes of the lumbar spine are detailed below:
- hereditary factor;
- one of the forms of obesity, excessive body weight, sagging belly;
- excessive physical exertion;
- uneven distribution of the load on the spine;
- impaired metabolism;
- the presence of bad habits;
- violation of posture;
- flat feet;
- production factor;
- exacerbation of chronic diseases of the spine.
It is important to find out what could have caused the signs of lumbar spondylarthrosis, on which the patient's health depends.
If the provoking factor is not eliminated, the person will continue to experience unpleasant sensations in the back, complaining of acute pain of the spine.
It is important to strengthen the muscle corset and restore the structure of the spine, and this requires a whole range of therapeutic measures.
Treatment of spondylarthrosis of the lumbosacral spine
One manual therapy is not enough to provide an extended period of remission. Deforming spondylarthrosis of the lumbar spine is treated with medications, causes the patient to get rid of bad habits and choose a new way of life for himself.
If the disease is not yet, but parents are predicting it to their children on a personal example, it is necessary to give the child to gymnastics or other sports related to exercises for stretching the spine.
There are a lot of therapeutic measures, but it's worth starting from bed rest. In case of exacerbation, the patient should lie more.
For relief of an acute attack of pain, the doctor recommends drug treatment, which includes the use of painkillers and anti-inflammatory drugs.
In a day hospital, symptomatic therapy is performed, in which such medications as Ketonal, Meloksikam, Movalis, Xsefokam, Ibuprofen, Nalgezin can be used.
The treatment is effective, since the active components enter the systemic bloodstream productively, provide a rapid relief of the pain, increase the chances of a full life.
To cure spondylarthrosis of the lumbar spine, complex treatment is needed, which includes a massage course, physiotherapy exercises and a number of physiotherapy procedures.
There are other therapeutic methods, among which magnetotherapy, physiotherapy, electrophoresis of chondroxide, electrocution, UHF therapy, spinal cord extract, ion-oligoversion, manual therapy.
The doctor will prescribe a specific procedure for medical reasons, give directions and send the patient to the day hospital. It can be yoga.
Below are the special exercises for spondylarthrosis of the lumbar spine, which provide weakening the tension of the muscles, relieve an acute attack of pain, ensure a uniform filling interval between vertebrae. They may not be prescribed, but recommended by the attending physician. You can conduct such exercises in a home setting:
- Lie on the floor (hard surface), stretch your legs and throw your arms over your head. At maximum stretch, two - to return to the starting position. This movement is prescribed for pinching of the vertebrae, with the formation of an intervertebral hernia.
- To remove pain, from the lying position it is required to perform deep breaths and exhalations, as much as possible relaxing. There is a relaxation of the muscles, as a result of which the painful sensations recede into the background.
- To exclude the fusion of the vertebrae and the formation of dangerous osteophytes, it is required to hang more often on the horizontal bar, and it is desirable to lift the legs at the angle of 90 degrees with respect to the body. Isometric gymnastics will not be superfluous.
Local drug therapy
This is part of an integrated approach to the problem, in addition, therapeutic ointments and compresses are best used for prevention.
Before treating spondylarthrosis of the lumbar spine, it is important to determine the medical preparations and small nuances of their appointment, to exclude the risk of skin allergic reaction.
Such medicines are used externally, for example, the ointment is shown rubbed into the skin in a thin layer, and the compresses are not removed until the matter dries completely.
If we talk about pharmacological products, the most favorable side has the following therapeutic ointments for everyday use in a home environment:
- Fastum gel;
Local chondroprotectors are also most effective on the pathology site, since they contribute to the rapid restoration of damaged cartilaginous tissue, accelerate the natural processes of cell regeneration. These are the following local home-made medicines:
If the spondyloarthrosis of the lumbar spine develops - what is it, says the doctor on diagnosis. When prescribing conservative treatment, it is possible to involve alternative methods of medicine that are safe for health.
Especially effective in the given direction compresses from herbal decoctions, which are desirable to use before going to bed, do not remove all night. You can trust the medicinal composition from the dried root of ginger, no less effective compress with bischofite.
It also helps with strong pains tincture of red pepper.
A source: http://sovets.net/11368-spondiloartroz-poyasnichnogo-otdela-pozvonochnika-chto-eto-takoe.html
Signs of spondylosis of the lumbosacral spine
Spondylosis of the lumbosacral spine is one of the diseases of the spinal column, characterized by degenerative-dystrophic processes in the vertebrae, when the bone part of the latter forms thorns, outgrowths beaks, which are called osteophytes. Spines narrow the intervertebral fissures, the nerve roots, partially the spinal cord, are squeezed. The spine loses its flexibility, because the vertebrae are compacted and even fixed.
Spondylosis of the lumbar spine is a complication of osteochondrosis, the next stage is the development of spondylarthrosis, followed by spondylosis. Often the last 2 diagnoses are considered synonymous.
The fibrous ring of the intervertebral disc is dystrophic, the pulpous nucleus in the body of the vertebra is protruded, and on the sides and in front of the vertebrae appear bone spines, the main manifestation of spondylosis.
The process can develop in any vertebral department, but more often in the lumbosacral in view of the greater load.
Any pathology of the spine becomes a significant social problem because it easily leads to disability.
Scientific and technological progress, new technologies are good, but people are less moving, there is a weakening of the muscles, development of dystrophic changes in them, as well as in the joints and bones.
Despite early lesions of the spine, spondylosis of the lumbosacral spine for a long time develops asymptomatically, beginning to manifest themselves after 50 years, so the pathology is considered to be destiny of the elderly.
In addition to the vertebrae, inflammatory processes involve arches of the vertebrae - small facet joints, which causes the disease to be called facet arthropathy.
Etiology of the phenomenon
Spondylosis of the lumbar spine is a polyethological disease. The main reasons for its occurrence:
- shock physical exercises of a regular nature among athletes, people engaged in heavy physical labor;
- spine trauma;
- pathology of connective tissue;
- frequent hypothermia;
- violations of protein and mineral metabolism (calcinates in excess accumulate in the joints, which leads to the growth of bone tissue and the appearance of thorns);
- elderly age;
- compression fractures;
- flat feet;
- intervertebral hernia;
- scoliosis (muscles are also overexerted, and the body starts regeneration processes with the formation of thorns);
- hypodynamia (it leads to a gradual atrophy of the muscles and ligaments of the spine, which ends with degeneration of the vertebrae).
Sprouting of bone spines (osteophytes) is nothing more than an attempt by the body to compensate for the onset of degenerative processes in the discs and joints.
He tries in this way to create a backup of the vertebral discs so that they do not fall out.
Spines prevent the displacement and prolapse of the vertebrae relative to each other.
Symptoms of spondylosis
Characteristic features of spondylosis:
- disturbance of sensitivity in the foot;
- sensation of crawling crawling, numbness in calves, tingling in the legs (manifestations of paresthesia);
- limitation of mobility in the lumbosacral region.
Diagnostic demarcation of spondylosis - a reduction in pain in the embryo position (curling up) and when tilting forward, since the load on the anterior longitudinal ligament of the spine in this position decreases - this is the difference between spondylosis and sciatica.
When spondylosis in the morning is always noted stiffness of movements in the lower back and legs, with attempts to move the synchronous increase in pain - evidence of the appearance of osteophytes.
Unpleasant sensations noticeably decrease after doing exercises and charging. Relief occurs after rest and reduction of load on the lower back.
Later, lameness and pain in the leg appear, which do not disappear at rest.
With palpation of the spinous processes, the neurologist discovers the appearance of pain in the patient necessarily. This is due to the squeezing of the nerve endings.
In later stages a new symptom appears: the patient is absolutely unable to unbend the knee.
In the absence of treatment of spondylosis of the lumbar spine, curvature of the spine increases, scoliosis develops. The volume of movements is also sharply reduced.
Spondylosis more often deforms 3 and 4 lumbar vertebrae, the sacrum is not affected; and with osteochondrosis - more often 5 lumbar and 1 sacral vertebra are affected. First, pain may not be, they appear later, in advanced stages, becoming stupid and permanent.
If there is a subluxation of the vertebrae, the pain becomes sharp and intense. In the absence of treatment, complete immobility may occur. When the process progresses, the posture changes; decreases the sensitivity of the skin; with pronounced infringement of the nerve roots, the sensitivity disappears completely.
There are 3 degrees of pathology:
- Spondylosis 1 degree - low back pain is periodic; 2 degree - the pain becomes constant and stiffness appears.
- Spondylosis of the 2nd degree already reduces the patient's quality of life, the patients can not fully work and need to be transferred to easy work or registration of 3 groups of disability.
- 3 degree - pains are expressed, there are paresthesias, movements are limited, disability is possible. All the symptoms in the spondylosis of the lumbar region can be combined into 3 groups: reflex, radicular and vascular. Reflex - these are all kinds of manifestations in the lumbar part: lumbago - attacks of sharp pain in the lower back, arising suddenly, immediately. More often associated with awkward movements, lifting of heaviness, coughing, etc. Thus there is a plentiful sweat. At rest the pain subsides slightly, but does not allow to move, appearing again.
Lumbalia, or lumbago, is prolonged back pain due to the development of radicular syndrome; strengthen when standing and calm down in a horizontal position. They are usually preceded by cooling. Pass themselves for a few days. But sometimes they transform into lumboschialgia.
Lumboscialgia - a combination of lumbar pain and sciatica: pain along the buttock, the back surface of the foot, but not up to the foot.
Radical-vascular changes - when ischemia develops in the areas of compression, the radicular veins and arteries also turn out to be compressed.
Paralysis and paresis of the legs may develop.
An experienced doctor can diagnose a diagnosis on the basis of complaints and symptoms.
The main method of diagnosis - radiography of the spine; pictures are taken in all 3 projections. Before the x-ray, the enema must be cleaned with an enema.
In the pictures, osteophytes differ clearly. There are several stages in the development of the process:
- The first stage - numerous pathological growths are fixed in the vertebra, but the discs are not changed, they remain normal.
- The second stage - the growth goes beyond the vertebrae; there are already many osteophytes. Osteophytes can connect, forming a new joint.
- Stage 3 - there is a fusion of osteophytes of several vertebrae.
Constant is and detachment from the vertebrae of the anterior longitudinal ligament.
Diagnosis involves the use of CT and MRI - they are more informative, as the study of the spinal column goes layer by layer.
Information on intervertebral discs, the condition of muscles and ligaments is visualized. Even small osteophytes will not be missed. Laboratory tests do not matter in the course of diagnosis.
Principles of treatment
If the spondylosis of the lumbosacral spine is identified, the treatment will be comprehensive and lengthy. Purpose of treatment:
- improve the state of intervertebral discs;
- reduce or completely stop the manifestations of pain;
- restore and improve the innervation of the spine;
- Create a muscular back corset and reduce friction between the vertebral bodies.
How to treat spondylosis? He uses conservative and surgical treatment. Surgeons very rarely engage in spondylosis, only by indications, which are paralysis of the legs, incontinence of urine and feces (horse tail syndrome).
There is no single remedy that cures the spine. You can not return the lost elasticity of tissues, but you can suspend the process. Conservative treatment includes:
- drug therapy;
- physiotherapy methods;
- therapeutic gymnastics;
- help manual chiropractor;
- laser treatment;
- symptomatic therapy;
- a diet with a decrease in salt is observed, with the exception of fatty and fast carbohydrates.
To relieve pain and reduce inflammation, improve microcirculation and restore cartilage tissue used NSAIDs and chondroprotectors, vitamins and angioprotectors.
Of the NSAIDs are prescribed salicylates, Indomethacin, Ketanov, Ibuprofen, Naproxen. NSAIDs alternate with blockades, muscle relaxants and analgesics.
Chondroprotectors can have an effect in the early stages of spondylosis; they are usually applied in combination - topically and inwardly. Take them for at least 3 months.
Angioprotectors - Pentoxifylline, Trental, Actovegin. To enhance metabolic processes apply vitamins A, C, group B, immunostimulants.
Physiotherapy: amplipulse (eliminates muscle spasms), electrophoresis, magnetotherapy (eliminates pain and reduces swelling), balneotherapy, ultrasound treatment, paraffin and mud therapy, phonophoresis with chondroksidom (removes inflammation and resolves scars); massage (improves blood circulation in the lumbar region and eliminates muscle blocks, and therefore reduces pain), regular medical gymnastics.
In spondylosis, gymnastics involves performing isometric exercises (staying in a certain position), while the muscle does not contract, but the muscular corset is created. It is very useful in spondylosis swimming, as with this is the unloading of the spine.
Manual therapy removes muscle spasm and stops pain syndrome. Reflexotherapy - acupuncture of special points - reduces pain and spasm of the muscles of the back; the body's own forces are mobilized.
Which doctor treats spondylosis? The neurologist always deals with the treatment of the disease, during the therapy, a massage therapist, a reflexotherapist, a manual and a physiotherapist, etc. are connected.
As an adjunct to the main treatment can be used and alternative in the form of various ointments, rubbing and compresses.
But this is only applicable when there is no pain syndrome.
To use folk remedies during spondylosis is not advisable - they will not be able to cure and relieve pain.
The patient should always know clearly that the treatment of spondylosis is a lengthy process, carried out under the supervision of a vertebrologist, and physiotherapy will have to be engaged all his life.
But this will prevent disability and will not give an additional expansion of osteophytes.
One can not help saying one more thing: there is a possibility of self-healing, when several osteophytes can grow together and form a block of several vertebrae.
Exercises are mostly static, they are carried out lying down, while the lumbar overextension and tilting of the head are not allowed.
Prevention consists in the normalization of body weight, daily special exercises, hourly physical training with sedentary work.
It is necessary to eat well, wear a corset while diagnosing spondylosis, and avoid supercooling.
In addition to the above, every six months, you need to see a doctor and examine the spine.
A source: https://OrtoCure.ru/pozvonochnik/prochee/spondilez-poyasnichno-kresttsovyj.html