Lumbar osteochondrosis: symptoms and treatment

Osteochondrosis of the spine is a common disease that lowers the quality of life of a person and is one of the causes of disability.

The pathology is more common in people over 40 years of age, is characterized by gradual progression, and therefore requires adequate conservative or surgical treatment.

Mechanism of development

The main mechanism of the development of osteochondrosis is the violation of nutrition of the cartilage tissue of the spinal structures.

The disease includes a number of pathogenetic relationships:

• Dystrophy of cartilage tissue due to nutrition is the main trigger of pathology.
• Degeneration (damage and destruction) of spinal cartilage (intervertebral discs, articular surfaces of vertebral processes).
• An inflammatory reaction with tissue swelling, blood stasis and pain.
• The change in the ratio of the anatomical structures of the spinal column (the flattening of the intervertebral discs with a decrease in their height) leads to a decrease in the diameter of the holes between the vertebrae through which the roots of the spinal cord pass.
• The compression of the nerve fibers of the roots of the spinal cord leads to the disturbance of the passage of impulses and the subsequent development of the corresponding neurological symptoms.

Changes in cartilaginous components develop gradually over a long period of time.Timely initiation of preventive and therapeutic measures allows to slow down the course of the disease.

Reasons

Osteochondrosis of the spine is a polyetiological disease that develops due to several reasons:

• Hereditary tendency that determines the nutritional properties of cartilage tissue at the genetic level.
• Diseases of the endocrine, digestive and cardiovascular systems.
• Inflammatory autoimmune diseases affecting the joints of the spine (rheumatoid arthritis, systemic lupus erythematosus, rheumatism).
• Metabolic disorders in the human body.
• Systematic hard physical work with increased loads on the spine, heavy athletics.
• Previous damage to the spine, especially in the lumbar region (the cause of the disruption of the connection of the vertebral components with the subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or defects of the spine.

The realization of the negative effect of the reason is more possible against the background of the following risk factors:

• Increased weight, which increases the load on the spine.
• The long-term systematic state of the human body.
• Wrong posture.
• Hypothermia, including local in the back region.
• Systematic exposure to stress, lack of sleep, irrational work and rest mode.

Knowing the causes and risk factors will allow you to take effective preventive measures.

Symptoms of lumbar osteochondrosis

The possible development of osteochondrosis is indicated by the appearance of the following characteristic symptoms:

• Pain in the lumbar region initially appears when the load on the spine increases.Then it becomes permanent, has a pulling or aching character and gradually gets stronger.
• Pain radiating to the leg on the side of the compressed spinal cord.
• Increased tone (tension) of the back muscles in the lumbar region.
• Decreased muscle strength in one or both legs.
• Periodic "shooting" pain in the back, provoked by local hypothermia and physical exertion.
• It is accompanied by loss of skin sensitivity, numbness and tingling in one or both legs.
• "Cold feet" - the skin becomes cold to the touch as a result of the spasm of the arterial vessels caused by compression of the vegetative nerve fibers of the spinal roots.
• Violation of sweating - the skin of the feet becomes dry or, on the contrary, sweating increases.
• Peeling of the skin in the area of sensitivity disturbance caused by the disturbance of autonomic innervation.

Osteochondrosis is a chronic disease.Clinical symptoms gradually increase over a long period of time.Periods of improvement (remission) are accompanied by an exacerbation of the pathology accompanied by an increase in clinical symptoms.After exposure to a provoking factor (hypothermia, physical and emotional stress, stress), it is possible to increase the pain provoked by the inflammatory reaction and swelling of the soft tissues in the area of the spinal roots as an acute attack.

Depending on the predominant symptoms, several clinical forms of the disease are distinguished:

• Lumbodynia is a periodic paroxysmal pain in the lower back that develops after exposure to provoking factors.
• Lumboischalgia - pain occurs in the lower back and spreads to the hips or legs.
• Radiculitis is a pathological process accompanied by compression of one or more roots, the clinical picture is dominated by neurological symptoms, including a violation of skin sensitivity and a decrease in muscle strength.
• Radiculoischemia - compression affects the arterial vessels and serious motor disorders develop.

Each clinical form of osteochondrosis does not develop separately;usually combined with each other.As it progresses, the person's condition worsens.Severe destruction of cartilage structures can lead to disability.

Diagnostics

The diagnosis of lumbar osteochondrosis is based on visualization of changes in vertebrae, intervertebral discs and soft tissues.

For this purpose, several instrumental research methods are prescribed:

• Radiography is a technique that allows you to visualize gross changes.It is widely available.
• Computed tomography is an X-ray method of layer-by-layer scanning of tissue, which has high resolution and allows visualization of minimal changes.
• Magnetic resonance imaging - tissue visualization is performed due to the effect of the resonance of the nuclei of organic substances in a magnetic field.It involves layer-by-layer scanning while eliminating radiation exposure to the patient's body.

An additional examination is prescribed to determine the nature and severity of possible functional changes in the body.This includes blood tests, urine tests, liver tests, kidney tests, and an electrocardiogram.Based on the analysis of all examination results, the doctor draws a conclusion and chooses the appropriate treatment.

Treatment of low back pain

Treatment of osteochondrosis of the lumbar spine is complex and includes several areas:

• General recommendations and diet.
• Drug therapy.
• Surgical intervention.

The choice of the direction of treatment is made by the doctor.Based on the results of clinical and additional examination, he prescribes the most optimal treatment.

General recommendations and diet

General recommendations, regardless of the severity of the pathological process, should accompany the treatment of lumbar osteochondrosis, which include:

• A balanced diet with the restriction of fatty fried foods and the exclusion of alcohol from the diet.
• Limitation of heavy physical activity, including the long stay of the human body in one position.
• Rationalization of work and rest mode - a short rest should be provided after each working hour (usually 10 minutes is enough).If you work standing or sitting, you can exercise a little while you rest.
• Giving up bad habits, because nicotine and alcohol accelerate the processes of cartilage tissue dystrophy and degeneration.
• Eliminating the influence of stress factors and negative emotions that worsen the course of any pathological process in the body.

Following general recommendations makes it possible to prevent the progression of the pathological process, as well as increase the effectiveness of other areas of therapy.

Drug treatment

Medicines are prescribed during the conservative treatment of osteochondrosis.

Medicines of various pharmacological groups are used:

• Non-steroidal anti-inflammatory drugs - reduce the severity of the inflammatory reaction in tissues and pain.It is prescribed to reduce the intensity of the manifestations of exacerbation of osteochondrosis.
• Muscle relaxants - drugs reduce the tone of the striated muscles in the spine, thereby reducing tissue tension and compression of the spinal roots.
• Adrenal hormones and glucocorticosteroids - reduce the inflammatory response.
• Diuretics - reduce the severity of edema in the soft tissues of the region of the spinal structures affected by the pathological process.Thanks to this, the manifestations of the pathological process are reduced and the damage to the spinal roots is reduced.
• Chondroprotectors are agents that protect cartilage tissue from damage and help to partially restore it.
• B vitamins - normalize metabolic processes in nervous tissue, improve the functional condition of damaged spinal roots after strangulation.
• Vitamin C (ascorbic acid) – improves the condition of microcirculation structures, has an antioxidant effect, binds and neutralizes free radicals ("fragments of organic molecules containing unpaired electrons" that damage cell membrane structures).

The dosage and duration of drug use is determined by the attending physician based on the results of research, as well as the effectiveness of previous therapy.

Surgical intervention

Surgery for osteochondrosis of the spine is indicated in the case of obvious changes, as well as in the absence of the necessary result after conservative therapy.The subsequent plastic surgery is aimed at eliminating the defects in the modified cartilage tissue.In modern medical institutions, surgical intervention is performed using minimally invasive endoscopic methods.In addition to surgical treatment, drugs are prescribed that help accelerate the healing process of the postoperative wound, as well as prevent the development of complications.By using modern minimally invasive methods, it was possible to significantly reduce the length of the patient's stay in the hospital.

Prevention

Prevention of the development of osteochondrosis of the lumbar spine involves following simple recommendations.It is important to limit the load on the spine, give up bad habits, rationalize the work and rest schedule, and ensure adequate sleep.The diet is aimed at limiting fried, fatty foods and ensuring a sufficient supply of vitamins, minerals and plant fiber.This will allow to normalize the functional state of the digestive system, as well as to improve the nutrition of the cartilaginous structures of the musculoskeletal system, and to slow down the degeneration processes.

The prognosis for life with osteochondrosis of the lumbar spine is favorable.The disease is characterized by gradual progression.In the absence of therapeutic measures, the clinical picture of osteochondrosis is accompanied by increasing symptoms.At the same time, the person's condition worsens and the manifestations become permanent.They cause significant discomfort and reduce the quality of life.To prevent the development of negative manifestations, you should immediately seek qualified medical help.