Lumbar osteochondrosis: symptoms and treatment.

Osteochondrosis of the lumbar spine is a common disease that reduces a person's quality of life 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 appropriate conservative or surgical treatment.

Development mechanism

The main mechanism for the development of osteochondrosis is a violation of the nutrition of the cartilaginous tissue of the spinal structures.

The disease includes several pathogenic links:

• Dystrophy of cartilage tissue due to malnutrition is the main trigger of the pathology.
• Degeneration (damage and destruction) of spinal cartilage (intervertebral discs, articular surfaces of vertebral processes).
• An inflammatory reaction with tissue swelling, blood stagnation and pain.
• A change in the proportion of the anatomical structures of the lumbar spine (flattening of the intervertebral discs with a decrease in their height), which leads to a decrease in the diameter of the holes between the vertebrae through which the roots of the spinal cord pass.
• Compression of the nerve fibers of the roots of the spinal cord, which causes interruption of the passage of impulses and the subsequent development of the corresponding neurological symptoms.

Changes in cartilage components develop gradually over a long period of time.The timely start of preventive and therapeutic measures makes it possible to slow down the progression of the disease.

Reasons

Osteochondrosis of the lumbar spine is a polyetiological disease that develops for several reasons:

• Hereditary predisposition that determines at a genetic level the nutritional characteristics of cartilage tissue.
• Diseases of the endocrine, digestive and cardiovascular systems.
• Autoimmune inflammatory diseases that affect the joints of the spine (rheumatoid arthritis, systemic lupus erythematosus, rheumatism).
• Metabolic disorders in the human body.
• Systematic heavy physical work with increased load on the spine, weight lifting.
• Previous injuries to the spine, especially in the lumbar region (the cause of a violation of the relationship of the components of the vertebrae with the subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or defects of the spine.

Understanding the negative impact of the cause is most possible in the context of the following risk factors:

• Weight gain, which increases the load on the spine.
• Systematic long-term permanence of the human body in a standing position.
• Wrong posture.
• Hypothermia, including local in the back area.
• Systematic exposure to stress, lack of sleep, irrational work and rest regime.

Knowledge of the causes and risk factors will allow effective preventive measures to be carried out.

Symptoms of lumbar osteochondrosis.

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

• Pain in the lumbar region, which initially appears when the load on the spine increases.Then it becomes constant, has a pulling or painful character and gradually intensifies.
• Radiation of pain in the leg from the root side of the pinched spinal cord.
• Increased tone (tension) of the back muscles in the lumbar region.
• Decreased muscle strength in one or both legs.
• Periodic "stabbing" pain in the back, caused by local hypothermia and physical exertion.
• Loss of skin sensitivity in one or both legs, which is accompanied by numbness and a tingling sensation.
• “Cold feet”: the skin becomes cold to the touch due to spasm of the arterial vessels, caused by compression of the autonomic nerve fibers of the spinal roots.
• Impaired sweating: the skin on the feet becomes dry or, on the contrary, sweating increases.
• Peeling of the skin in the area of impaired sensitivity caused by a violation of autonomic innervation.

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

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.
• Lumboiscalgia: pain occurs in the lower back and radiates to the buttocks or legs.
• Radiculitis is a pathological process accompanied by compression of one or more roots, while the clinical picture is dominated by neurological symptoms, including altered skin sensitivity and decreased muscle strength.
• Radiculoischemia: compression affects the arterial vessels and serious motor disorders develop.

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

Diagnosis

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

For this, several instrumental research methods are prescribed:

• Radiography is a technique that allows you to visualize macroscopic changes.It has become widespread due to its accessibility.
• Computed tomography is an X-ray method of scanning tissue layer by layer, which has high resolution and allows minimal changes to be visualized.
• Magnetic resonance imaging - visualization of tissues is carried out due to the effect of resonance of the nuclei of organic substances in a magnetic field.It involves layer-by-layer scanning, while removing radiation exposure from the patient's body.

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

Treatment of the lumbar spine.

Therapy for 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, the most optimal treatment is determined.

General recommendations and diet.

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

• A balanced diet that limits fried fatty foods and excludes alcohol from the diet.
• Limit intense physical activity, including prolonged stay of the human body in one position.
• Rationalization of the work and rest regime: after each hour of work, a short break should be provided (usually 10 minutes is enough).If you work standing or sedentary, you can do a little exercise during your break.
• Quit bad habits, since nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilage tissue.
• Eliminate the impact of stressors and negative emotions that worsen the course of any pathological process in the body.

Following general recommendations allows you to prevent the progression of the pathological process, as well as increase the effectiveness of other areas of therapy.

Pharmacological treatment

The prescription of medications is carried out during conservative treatment of osteochondrosis.

Drugs from various pharmacological groups are used:

• Non-steroidal anti-inflammatory drugs: reduce the severity of the inflammatory reaction in the tissues and pain.Prescribed to reduce the intensity of the manifestations of exacerbation of osteochondrosis.
• Muscle relaxants: Medications reduce the tone of the striated muscles of the spine, which reduces tissue tension and compression of the roots of the spine.
• Adrenal hormones and glucocorticosteroids: reduce the inflammatory response.
• Diuretics - reduce the severity of edema in the soft tissues of the area of the spinal structures affected by the pathological process.Thanks to this, the manifestations of the pathological process are reduced and the infringement of the spinal roots is reduced.
• Chondroprotectors are agents that protect cartilage tissue from damage, and also contribute to its partial restoration.
• B vitamins - normalize metabolic processes in the nervous tissue, improve the functional state of spinal roots damaged after strangulation.
• Vitamin C (ascorbic acid) - improves the state of microcirculatory structures, has an antioxidant effect, which is achieved by binding and neutralizing free radicals ("fragments" of organic molecules that contain an unpaired electron and damage the membrane structures of cells).

The dosage and duration of use of the drug are determined by the treating doctor based on the results of the research, as well as the effectiveness of the previous therapy.

surgical intervention

Surgery for osteochondrosis of the lumbar spine is indicated in case of pronounced changes, as well as in the absence of the necessary result after conservative therapy.Its objective is to eliminate defects in the altered cartilage tissue with subsequent plastic surgery.In modern medical institutions, surgical intervention is performed using minimally invasive endoscopic techniques.Along with surgical treatment, medications 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 techniques, it was possible to significantly reduce the patient's time in the hospital.

Prevention

Prevention of the development of osteochondrosis of the lumbar spine includes following simple recommendations.It is important to limit the load on the spine, abandon bad habits, rationalize the work and rest schedule, and ensure adequate sleep.The diet aims to limit fried and fatty foods and ensure a sufficient supply of vitamins, minerals and vegetable fiber.This will normalize the functional state of the digestive system, as well as improve the nutrition of the cartilaginous structures of the musculoskeletal system, slowing 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 an increase in symptoms.At the same time, the person's condition worsens and the manifestations become permanent.They bring significant discomfort and reduce the quality of life.To prevent the progression of negative manifestations, you should quickly seek qualified medical help.