Osteochondrosis is a widespread disease of the spine, which affects the intervertebral discs and cartilage. The cervical and lumbar areas are more sensitive to such processes. Osteochondrosis of the lumbar region can cause constant pain in the lower back and significantly complicate a person's life. In the treatment of the disease, conservative methods are preferred, surgical interventions are resorted to only in extreme cases.
Causes of lumbar osteochondrosis
Osteochondrosis is not so much a disease as it is often a natural phenomenon that occurs as a result of age-related degenerative changes in the spine. Normally, the disc in the lumbar spine acts as a shock absorber between two vertebrae and allows the joints and spine to move easily. The outer part of the disc, the annulus fibrosus, surrounds the soft inner core of the disc, the nucleus pulposus. Everyone's spinal discs undergo degenerative changes as they age, but not everyone shows symptoms.
Osteochondrosis is believed to begin with changes in the annulus fibrosus, intervertebral disc, and subchondral bone. The annulus fibrosus loses water, which makes it less able to withstand the daily loads on the spine, distributing them incorrectly. Overloading of the posterior part of the vertebra leads to arthritis of the facet joints and hypertrophy (growth, with the formation of osteophytes - bone growths) of the vertebral bodies next to the affected disc.
Report! According to statistics, 30% of people between the ages of 30 and 50 have some degree of spinal disc degeneration.
There are two main pathophysiological causes of pain in lumbar osteochondrosis. One of the possible causes of pain is inflammation of the nerves as a result of the outer part of the disc rupturing and the inner core leaking out. Inflammatory proteins are released, which irritate the nerve tissue.
According to the second reason, the vertebrae, due to age-related deformation, are no longer able to effectively absorb the load. This causes abnormal movement of the spine and causes a painful spasm of the back muscles that try to stabilize the spine.
The result of osteochondrosis can be the destruction of parts of the spine, leading to radiculitis. Risk factors that trigger and accelerate degenerative processes in the spine are:
- Hereditary predisposition to diseases of the musculoskeletal system.
- Smoking;
- Previous injuries.
- Hormonal and vascular disorders?
- Excess body weight?
- Muscles that are too weak and do not provide the necessary support to the spine.
- Professional activities related to heavy physical work (athletes, loaders).
Stages of development of lumbar osteochondrosis
Disorders in the intervertebral discs, which lead to their degeneration and destruction, appear gradually. The entire pathological process goes through several stages, according to which the stages (or degrees) of lumbar osteochondrosis are distinguished:
- The first stage (grade) is characterized by mild symptoms. Painful sensations develop against the background of irritation of nerve endings from the nucleus pulposus, penetrating the fissures of the annulus fibrosus.
- The second stage is characterized by displacement of the upper vertebra in relation to the lower one, due to a crack in the nucleus and annulus. These pathological processes, in addition to pain during movement, cause the appearance of neurological symptoms, sensations of numbness and instability of the affected area.
- The third stage is characterized by an increase in pain and the appearance of herniated intervertebral discs, due to a violation of the integrity of the annulus fibrosus. Pain, sensory impairment, and muscle weakness interfere with daily tasks. Due to the pinched nerve roots, the functioning of the urinary and intestinal systems can be disturbed.
- The fourth stage corresponds to complete destruction of the intervertebral discs, they become fibrous and the osteochondral growths of the vertebral bodies cause immobility of the spine in this section.
Symptoms of lumbar osteochondrosis
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The main symptom of lumbar and sacral osteochondrosis is pain. It is usually aggravated when sitting for long periods of time or when twisting, bending the spine or lifting a load. The pain can radiate to the leg, groin and be accompanied by a feeling of numbness and weakness. Moderate, aching, dull pain may be followed by flare-ups.
The symptoms directly depend on the stage of development of the pathology:
- In the early period, when the degenerative changes are just beginning to appear, the symptoms are minimal.
- The intermediate stage, which is characterized by a weakening of the annulus fibrosus, can already manifest itself as lower back pain.
- In the later stage, when fibrosis develops in the structures and osteophytes are formed, the pain becomes less intense, but the mobility of the spine is significantly reduced.
Lower back tenderness may increase when you touch it. Characteristic pains in the buttocks, thighs and tingling are a sign of nerve root pinching that occurs as a result of degenerative changes in the disc. Patients with lumbar osteochondrosis have difficulty bending forward, backward, and sideways. Osteochondrosis can be complicated by disc herniation and spinal canal stenosis, accompanied by the appearance of additional symptoms.
Diagnosis of lumbar osteochondrosis
Diagnosis begins with the collection of memories, interview and examination of the patient. The specialist will be interested in your complaints, physical activity, the presence of old injuries, bad habits and cases of illness in close relatives. During a physical exam, the doctor palpates (feels) the lower part of the spine, looking for tender areas, inflammation, or any abnormalities. He can also check sensation and do motor tests.
The most popular method for diagnosing lumbar osteochondrosis is X-ray. The image will show the presence of osteophytes, narrowing of the articular space of the disc or the so-called "gap" symptom, when gas bubbles are detected in the thickness of the disc. Other methods used are:
- MRI shows hydration (the degree of water saturation), the shape of the discs, their height, which allows the identification of pinched nerves.
- CT scan, which allows you to study the state of the tissues in detail and diagnose disorders in the early stages.
- Provocative discography used to determine the location of the affected disc.
Report! Magnetic resonance imaging is a fairly accurate diagnostic method, but it cannot detect a rupture of the outer rings of the disc.
Treatment methods for lumbar osteochondrosis
The preferred treatment for lumbar degenerative disc disease associated with chronic pain is conservative treatment with physical therapy, exercise, and medications. For patients with lumbar osteochondrosis it is recommended:
- A daily routine that includes adequate rest and adequate physical activity.
- Regular physical exercise aimed at strengthening the muscles.
- Lifestyle modifications, including dietary revision and weight loss.
Physiotherapy
Various physical therapy techniques have been used successfully to reduce low back pain. Physiotherapy promotes regenerative processes in the disc, stimulates metabolic and transport processes, prevents the formation of adhesions and further damage.
Physiotherapy methods used to treat vertebral osteochondrosis include:
- Electrical stimulation. Electrical impulses help relieve back pain and improve blood circulation in the affected spine.
- Ultrasound therapy. Ultrasound waves can penetrate deep layers of tissue and help relieve inflammation and pain.
- Magnetic therapy. Magnetic fields can improve blood circulation and metabolic processes in tissues, promoting their regeneration.
- Laser treatment. Laser rays can help relieve pain, stimulate blood circulation and stimulate tissue regeneration.
- Hyperphonophoresis. This method combines ultrasound therapy with the use of drugs that penetrate deep tissue layers and help relieve inflammation and pain.
Great! Contrary to popular belief, osteochondrosis can and should be treated. Left untreated, it will become a source of chronic pain and can lead to numerous problems, including dysfunction of internal organs.
Pharmaceutical treatment
To relieve pain that interferes with daily activities, patients are prescribed analgesics and non-steroidal anti-inflammatory drugs. According to indications, the doctor can prescribe stronger drugs: muscle relaxants, steroids and narcotic pain relievers. Therapeutic blocks are administered with local anesthetics and glucocorticoids to relieve severe pain.
Surgery
Much less often, surgery is used for osteochondrosis of the lumbar region. It may include disc replacement or lumbar spine fusion (creating conditions for the fusion of two vertebrae, while pain is reduced by eliminating movement in that part of the spine).
If the movement of the spine is significantly reduced, special intervertebral spacers can be placed. For patients who do not respond to all other treatments, a total lumbar disc replacement may be performed.
Treatment of lumbar osteochondrosis at home
The most effective thing you can do at home to maintain function and control pain is exercise. They will increase the flow of blood, oxygen and nutrients to the spine, helping to keep the cartilage hydrated and the spine flexible for as long as possible. In addition, endorphins are released during exercise, which are natural pain relievers.
Frequent changes of position also bring relief. Certain positions help to cope with an attack of pain: kneeling, leaning, lying down. A short rest is necessary and beneficial, but prolonged bed rest only worsens the condition. It is important to stay active to prevent the disease from progressing. Patients with lumbar osteochondrosis benefit from walking, swimming, cycling, yoga, Pilates, stretching exercises and muscle corset strengthening. The following measures also help:
- Applying heat to the lower back improves blood circulation and relieves muscle spasms and tension.
- Ice packs will help relieve pain and reduce inflammation.
- Massage also relaxes muscles, relieves spasms and reduces pressure on the spine, thus relieving pain. By increasing blood circulation in this area, metabolic processes improve and tissues are enriched with oxygen.
- Use of orthopedic mattresses and pillows. They will help maintain the correct position of the spine during sleep.
- Correct distribution of the load on the spine. When lifting heavy objects, you should use proper lifting technique to avoid straining the lumbar spine.
- Proper nutrition. Eating a balanced diet rich in calcium and vitamins will help maintain healthy bones and joints.
However, if you have pain or other symptoms, before starting treatment for osteochondrosis at home, you should consult your doctor to get more accurate recommendations and assess the condition of the spine.
Which doctor should I see for lumbar osteochondrosis?
If symptoms characteristic of lumbar osteochondrosis appear, it is recommended to consult a neurologist or orthopedic doctor. If you have lower back pain, you can also make an appointment with a therapist. He will prescribe the necessary tests to make the diagnosis and refer you to a specialist.
Treatment of lumbar osteochondrosis
Specialists from the nearest clinic in your city or in another location are ready to understand the reasons and help to cope with the pain. Doctors usually have extensive clinical experience and possess all modern methods of treatment and diagnosis of osteochondrosis in women and men. For the most part, the convenient location, excellent equipment and flexibility of institutions are a priority of modern medicine, which allow you to quickly undergo any examination and restore the health of the musculoskeletal system. You can make an appointment by calling a clinic that suits you, as well as on the website by filling out the online form.
Prevention of lumbar osteochondrosis
Effective methods for the prevention of lumbar osteochondrosis are:
- Regular physical activity. Maintain good physical condition. Strengthen your back muscles. Stretching and strengthening exercises for your back will help keep your spine healthy.
- Reduce pressure on the spine: Avoid unnecessary pressure on the spine. When lifting heavy objects, use proper lifting technique.
- Posture correction: ensure proper posture. Sit and stand straight, don't slouch. Choose an orthopedic pillow and mattress for sleeping to maintain the correct position of the spine while you rest. Buy quality shoes with good cushioning and support.
- Take care of back support using orthopedic chairs if, due to the nature of your profession, you are forced to sit for long periods of time. Avoid staying in one position for a long time. Take regular breaks and stretch your spine.
- Watch your weight. Being overweight can put extra pressure on the spine.
- Avoid uncontrolled movements and back injuries. Be careful when doing sports or physical activity.
- Quit smoking, which can negatively affect the health of your spine.
By following simple recommendations, you can live an active and full life, minimizing the risks of back pain. If you already have symptoms, lumbar spine pain, be sure to consult a doctor for diagnosis and treatment.