Pain in the back and waist is one of the most common complaints in medicine.They are in second place in terms of the number of all requests, second only to respiratory diseases.Various types of pathology can cause pain in the lower back, but most often it is caused by osteochondrosis of the lumbar region.How to treat such a disease, what are its symptoms and signs, will be discussed below.
Not so long ago, medical science believed that osteochondrosis in the lumbosacral region occurs solely due to age-related changes that lead to wear and tear of the vertebrae and intervertebral discs.However, today the symptoms of age are not exclusive;osteochondrosis of the lumbar spine is diagnosed in patients of various age groups.Today, the cut-off age is considered to be more than 25 years.
Causes of lumbar osteochondrosis
It is impossible to name the exact reason;almost always it will be a complex effect of various destructive factors, among which the most important can be identified:
- Commitment to a passive lifestylefrom the point of view of motor activity.By their own will, immobile people, for example, spending many hours at the computer, do not receive enough useful load, which is why the "corset" muscles relax and the load on the vertebrae increases.In addition, almost always such a hobby is associated with prolonged exposure to wrong and inappropriate positions.
- Problems with hormone levels, leads to metabolic disorders, which affect the metabolism of spinal tissue in the lumbar region and contribute to the destructive process.This also includes diseases of an endocrine nature.
- The presence of congenital or acquired abnormalitieswhen the musculoskeletal system undergoes certain changes.This may be reflected in increased load on the spinal column, for example, in patients with flat feet, curvature of the legs or spine.
- Chronic weight gainon the lower back.Here, the risk includes people with certain types of professional activity, usually associated with heavy lifting.This also includes professional athletes who constantly subject their bodies to peak loads.
- Food intake and daily routine are disrupted.This also includes frequent exposure to stress.These factors affect the metabolic process and affect the periodic recovery of the body's strength.
Stages of osteochondrosis of the lumbar spine
The above pathological factors gradually lead to the manifestation of the disease.However, it can manifest in different ways, being practically asymptomatic at the beginning or causing unbearable pain during late development.Let's consider the main stages of the development of osteochondrosis:
- A condition in which the nucleus pulposus moves within the intervertebral disc.It is characterized by pain caused by irritation of the nerve root of the fibrous ring and longitudinal ligament.Discomfort is felt locally in the area where the damaged disc is located.The pain can be either acute with shooting or constant dullness.
- When the fibrous layer of the intervertebral disc is destroyed, the mobility of the elements of the spinal column in this area increases, they become unstable relative to each other.To eliminate this pathological manifestation, it is necessary to constantly keep the muscles of this area tense, which eventually leads to chronic fatigue in the lower back.
- Next, a breakthrough occurs in the fibrous ring, which causes the nucleus to escape outside the disc boundary, forming an intervertebral hernia.Such cases will be accompanied by pinching of nerve endings, which is called "radicular syndrome."
- The next stage of osteochondrosis of the lumbosacral region occurs with severe deformation of the spine in this part.Problems with mobility appear, but the pain syndrome, oddly enough, subsides at this stage.However, you should not rejoice;this does not mean that the disease is dying out.
- The last stage is characterized by pathological growth of bone tissue and a general deterioration in health.
Based on the level of lumbar osteochondrosis, certain treatment methods are used.
Symptoms of osteochondrosis in the lower back
The main symptom is the battle syndrome in the lumbar spine.At the same time, pain sensations, their localization area and the direction of their spread may vary.This happens due to the fact that, based on the degree of damage to the intervertebral disc and surrounding tissue, certain nerve receptors become irritated.In addition, the presence of the protrusion or hernia itself, the direction of its protrusion and many other factors play a role.
The main symptoms of osteochondrosis of the lumbar spine include:
- The presence of pain in the lower back, which tends to increase with sudden movements or, on the contrary, remains without changing position for a long time.The pain decreases if you take a horizontal position.
- In addition, weakness in the area of the body below the abdomen, including the bottom, is likely, as well as dull tendon reflexes in the legs.
- There is a high probability of curvature of the lumbar spine.There are classifications of such curvatures, for example, when the emphasis is on the right or left side, they talk about scoliosis, lordosis is a state of forward bending, and kyphosis is a case when the natural lumbar curve is, as it were, smoothed.
- With a serious stage of development of the disease, pinching of the spinal canal is possible, which can cause its dysfunction and cause uncontrollable urination and defecation.
Additional symptoms include:
- The presence of numbness and "coldness" of the skin of the lower back and buttocks.
- Peeling, dry and blue skin in the same place.
- Interrupted urination.
- Erectile problems.
The presence of these symptoms should alert a person;one should not give up on them, this will only lead to greater neglect.In this case, you should definitely see a doctor for proper diagnosis and treatment.By the way, treatment can be either in a hospital setting or at home, but more on that a little later.
Disease diagnosis
When making a diagnosis, it is important to understand how far the disease has progressed.The easiest way is palpation in the lumbar region to identify the area of pain.Usually, this method is not very informative and in addition, an examination is carried out that gives a more detailed clinical picture:
- With radiography, an inexpensive and widespread method, it is possible to assess the condition of both the spine as a whole and individual vertebrae, for example the lumbar region in question.The technique is not very precise;it only allows us to indirectly understand how intact the intervertebral discs and spinal canal are.
- Computed tomographya more accurate method that allows you to assess the degree of damage to the disc between the vertebrae, nerve roots and channels with the spinal cord.
- Magnetic resonance imagingthe most accurate method, provides a complete picture of the lesion in detail, but is relatively expensive and inaccessible.
It should be noted that the diagnostic process is very important, because all the details of the developed osteochondrosis are important for the doctor when prescribing treatment tactics.
Complications of osteochondrosis
The main complications of pathology are hernias and protrusions, which inevitably occur if treatment is neglected and the development of the disease is left to chance.Other complications may include:
- Inflammation of the sciatic nerve.
- Spondyloarthrosis.
- Schmorl's hernia.
- Spondylosis.
- Problems caused by a pinched spinal canal.
- Functional disorders in the pelvis.
- The development of lameness.
Treatment of lumbar osteochondrosis
When diagnosed with osteochondrosis of the lumbar spine, various therapies are required, the main aspects of which are:
- Moderate load use.
- Special medicine.
- Traction of the spinal column.
- Manual therapy sessions.
- Physiotherapy.
- Therapeutic massage.
The concept of "treatment" for osteochondrosis implies:
- Suppression of inflammation.
- Relieves pain syndrome.
- Complex to strengthen the lumbar and adjacent muscle groups.
- Relieves chronic muscle tension.
- Improves the function of organs in the pelvis.
- Normalization of blood circulation and metabolism in pathological areas.
Treatment with drugs
The same approach to the treatment of lumbar osteochondrosis includes taking drugs, injections of special drugs, and the use of ointments and gels for external use.The main task of the drug is to neutralize pain and inflammation.
Based on the degree of osteochondrosis of the spine in the lumbar region, the doctor may prescribe the following drugs:
- Analgesics that have an analgesic effect.
- Anti-inflammatory drugs of non-steroidal origin.
- For muscle spasms, antispasmodics.
- Medicines for the restoration of cartilage tissue, called chondroprotectors.Their effectiveness has not been proven, so they are rarely used in traditional medicine.
- For serious pathologies, when the above drugs do not help, use corticosteroids.
- Vitamin complex.
In addition to these drugs, drugs are prescribed in tablets, the purpose of which is to calm the nervous system and combat stress and depression.
Physiotherapy treatment for lumbar osteochondrosis
The treatment process is rarely limited to just taking pills.The pathology in question cannot be cured without stimulating the spinal recovery process.For this purpose, various physiotherapeutic procedures are used, the most popular of which are:
- Phonophoresis.
- Therapy with diadynamic current.
- Laser therapy.
In addition, the spine needs to be given a useful load while simultaneously stretching it.Various types of therapeutic massage are suitable for this.Keep in mind that massage is only used when the pain has gone.As a rule, it is carried out as a rehabilitation measure when the disease remission process has begun, or in chronic osteochondrosis.After the massage, the muscles of the muscles that are too tense due to illness become well relaxed;the effect will be significantly enhanced when heated simultaneously, for example in a bathhouse or sauna.In the second case, we will achieve the maximum effect due to the additional stimulation of blood circulation in the pathological zone and adjacent areas.
Another method of physical therapy is manual therapy.The advantages are generally the same as the massage, but in addition, with the help of such techniques, the specialist can return the displaced vertebrae to their normal position.
Therapeutic gymnastics
Therapeutic exercise is also used as a rehabilitative and preventive measure during periods when pain and inflammation have already subsided.The key to the high effectiveness of therapeutic exercises is regularity of exercises;in this case, the damaged area will always receive the physical activity necessary for self-generation of new tissue and recovery.
Surgical operation for lumbar osteochondrosis
Surgery is a last resort, reserved for serious complications.The most common is an intervertebral hernia, when the so-called "discectomy" or removal of the affected intervertebral disc is performed.This operation is very effective, however, as a last resort, it is prescribed only if other methods of therapy have failed for more than 6 months.Modern medicine also offers less traumatic methods to perform such operations, for example, microsurgical or endoscopic methods.