Lumbar osteochondrosis is a degenerative and dystrophic disease of the lumbar spine.With the development of the disease, the intervertebral discs suffer most, the damage also extends to the joint surfaces, ligaments, vertebrae.
The share of osteochondrosis of the spinal column is 80% of all diseases of the peripheral nervous system.In 60–80% of cases, this is lumbar osteochondrosis.At least 7 out of 10 people experience regular lower back pain throughout their lives.For periods of exacerbations, on average, 3 to 16 days a year account for.But the disease can and should be treated to maintain high quality life and the health of the musculoskeletal system.We will tell you why this disease develops, how it manifests itself, and what the treatment of osteochondrosis of the lumbar spine should be.
What is osteochondrosis
Osteochondrosis is a chronic spine, which is accompanied by a change in the structure (destruction) and a decrease in the volume (dystrophy) of the intervertebral discs.They begin to stick out into the spinal cord and squeeze the blood vessels.Additionally, the disease is characterized by the destruction of the arched joints between the spinous processes of the vertebrae.
With osteochondrosis, osteophytes are also formed.This is the name of pathological growths, which are a consequence of the marginal growth of bone.He is facilitated by a violation of calcium metabolism in the vertebrae and high loads that cause their deformation.
Attention!Lumbar osteochondrosis is characterized by all pathological processes inherent in osteochondrosis in general.But they affect only the lumbar spinal column, which includes 5 vertebrae.
The reasons for development and risk factors
To understand the causes of osteochondrosis of the lumbar region, you need to know the structure of the spine.It is a column composed of the vertebrae, which are connected to each other intervertebral discs and ligaments.The holes inside them form a hollow channel.Inside it is the spinal cord, the roots of which come out between each pair of vertebrae.
When a person leans, the spine bends.In the place of fold, intervertebral discs are compacted, and their cores are displaced.This reduces the pressure on the spinal column during loads.Thus, the intervertebral disc is a biological shock absorber.When he ceases to perform a shock -absorbing function, osteochondrosis develops.
The following factors predisposed to the development of pathology:
- Sedentary or too hard work.In the sitting position, the muscles of the corset are relaxed, which increases the load on the spine.Heavy lift leads to this.
- Hypodynamia.In people leading a sedentary lifestyle, the muscle corset is not developed strongly enough to hold the spine in the correct position.
- Excess body weight.Excess weight presses on the spinal column and overloads it.
- Endocrine diseases.Hormones affect metabolism, including intra -national.Hormonal imbalance can lead to a violation of calcium metabolism.
- Improper nutrition.Insufficient intake of vitamins, minerals and protein disrupts the nutrition of the spine and leads to changes in its tissues.
- Pathology of the musculoskeletal system.Osteochondrosis can occur against the background of flat feet, injuries and curvature of the spinal column.
- Genetic predisposition.The risk of developing osteochondrosis increases if it has close relatives.
- Age -related changes.With age, elasticity and mobility of the spine decrease.
In men, osteochondrosis of the lumbar spine is more common.This is due to the fact that their work is often associated with heavy physical labor.Men are also undergoing large loads during strength training in the gym.
Symptoms of lumbar osteochondrosis
Pain is the main sign of the disease.Its character, localization and direction of distribution are determined by the receptor that was clamped in the spine.Typically, patients complain of aching pain, which intensifies with a change in body position, a long absence of a change in the pose and sudden movements.With lumbar osteochondrosis, she often gives him to the leg, sacrum or groin.In a horizontal position, the pain subsides.
Other possible symptoms of lumbar osteochondrosis:
- A sense of tension in the lower back arising from bending and extension.It is caused by a displacement of the spinal cord roots.
- A feeling of weakness in the legs.Perhaps the extinction of tendon reflexes in them.This is due to compressing the nerve fibers conducting signals from the brain to the lower limbs.
- The curvature of the lumbar spinal column to the side (scoliosis) or forward (lordosis), smoothing its natural bends (kyphosis).
- Involuntary urination and defecation (if the spinal cord is clamped).For the same reason, an erection may be impaired in men.
- The cooling of the lower back.The buttocks can also become cold.This happens with lumbosacral osteochondrosis, the symptoms and treatment of which are similar to pathology, localized only in the lower back.
- Violations of sensitivity in the area of damage.They can last from a few minutes to several hours.Sensitivity may increase, decrease or disappear.Perhaps the development of paresthesia - feelings of tingling and crawling goosebumps.
Osteochondrosis of the lumbar spine, the symptoms and treatment of which we will analyze in this article, is an insidious disease.It begins with discomfort and mild pain.But they are ignored because they quickly pass after rest.Over the years, pathology progresses, its signs are enhanced.And only when the pain becomes unbearable, patients seek medical help.
Degree of lumbar osteochondrosis
The development of lumbar osteochondrosis includes 4 stages:
- The first stage is characterized by the displacement of the core of the intervertebral disc.It is accompanied by a weak dull lower back pain, intensifying during movement.A short tingling in the back and buttocks is possible.
- In the second stage, the fibrous ring of the intervertebral disc is destroyed, which leads to the rapprochement of the vertebrae.They squeeze the nerve endings, which causes severe pain while walking.It can spread to the buttocks, thigh and lower leg.If you bend back, the pain is inferior to burning, sometimes a feeling of cold.
- In the third stage, complete destruction of fibrous rings occurs.Propes (hernias) appear - protruding intervertebral discs in the spinal cord.The vertebrae of the lumbar department are deformed.The pain is felt constantly, but at rest it is weaker.
- At the last stage, osteophytes are formed, the cartilage tissue of the spine is destroyed.The pain then subsides, then aggravates with renewed vigor.Body movements become limited.
Early diagnosis of osteochondrosis of the lumbar region, the symptoms and treatment of which are closely interconnected, is very important.The less pathology manifests itself, the more effective it is treated.Therefore, a doctor should visit when any incomprehensible back pain and lower back appear.
Possible complications
If there is no treatment for 1 and 2 degrees of development of lumbar osteochondrosis, intervertebral hernias are formed.This indicates the transition of the disease to the late stages and threatens the development of complications such as:
- inflammation of the sciatic nerve;
- arthrosis (destruction) of the intervertebral joints;
- destruction of the fibrous ring of intervertebral discs;
- narrowing of the intervertebral channel;
- spinal cord dysfunction as a result of compression;
- horse tail syndrome;
- Schmorl hernia;
- lameness and stiffness of movements.
Properly selected treatment will help to prevent the formation of hernias with lumbar osteochondrosis and other complications.It is prescribed after a diagnostic study of the patient.Otherwise, the disease will continue to progress, which can lead to the development of disability.
Diagnostic methods
With lower back pain, you should contact a neurologist.He will listen to complaints, examine and feel his back, ask about existing diseases.Additionally, the doctor may prescribe:
- X -ray.An X -ray picture of the spinal column will help assess the condition of the intervertebral discs and spinal cord.In the absence of visible changes, lumbar osteochondrosis of the 1st degree is diagnosed.
- Computer tomography (CT).Assign if an X -ray has shown changes in the lumbar spine.With its help, you can evaluate the degree of damage to the discs, nerve endings and the shell of the spinal cord.
- Magnetic resonance tomography (MRI).It is an alternative to CT, which can be prescribed in the presence of contraindications to an X -ray study.Suitable for pregnant and lactating women.
Sometimes computed and magnetic resonance tomography is carried out with intravenous administration of contrast.This is the name of a substance that highlights the fabrics from the inside.With it, you can get the pictures of the spine of the maximum quality.CT and MRI with contrast are carried out to exclude tumors with symptoms uncharacteristic for lumbar osteochondrosis, and treatment in this case is postponed to the final diagnosis.
Treatment of lumbar osteochondrosis and its types
The doctor prescribes treatment taking into account the stage of development of pathology.It is designed to eliminate pain, stop inflammatory processes, restore metabolism and blood circulation in the area of lesion.With osteochondrosis of the lumbar department, treatment also involves the adoption of a complex of measures aimed at strengthening the lower back, legs and buttocks.
Most treatment methods are conservative.They include drug therapy, physiotherapeutic procedures and physiotherapy exercises, folk remedies.When switching to 3 degree, treatment of osteochondrosis of the lumbosacral spine with conservative methods does not always lead to the desired result.In this case, the patient's condition may facilitate surgery.
Treatment with medicines
Drug therapy is effective at 1 and 2 stages of pathology.But it is important to remember that the selection of drugs is determined by the symptoms caused by lumbar osteochondrosis, and the treatment is a strictly prescribed treatment by medicines.You can’t just come to the pharmacy and ask a remedy for osteochondrosis.Even if it is sold to you, treatment will not be effective.
The patient can be shown the following groups of drugs:
- Analgesics.They help get rid of intense impenating pain in osteochondrosis of the lumbar.They can be used locally (ointments, gels), taken inside (tablets) or administered intramuscularly using a syringe (solution).
- Nonsteroidal anti -inflammatory drugs.They have a triple action: reduce temperature, relieve pain, reduce inflammation.They are prescribed if, with lumbar osteochondrosis, the lower back hurts, or the sciatic nerve is inflamed.To relieve pain, gels are locally use, to combat inflammation, take pills or injections.
- Musorelaxants.This is the name of remedies that relieve painful muscle cramps.They are taken orally in the form of tablets or administered intramuscularly in the form of a solution.
- Chondroprotectors.Provide effective treatment of lumbar osteochondrosis with medicines in the early stages, provided that its full course is passed.This group of drugs stops the destruction of the intervertebral discs and regenerates them.
To restore intraosseous metabolism, the patient is additionally prescribed vitamins and vitamin-mineral complexes.The doctor may also recommend compliance with the diet.Its goal is not only a decrease in body weight, but also the enrichment of the body with protein, natural vitamins and minerals.
Physiotherapy
With osteochondrosis of the lumbar spine, treatment with drugs is not enough.It should also include physiotherapeutic methods.They relieve pain, relax muscles and restore local metabolism.Often, patients are prescribed the following procedures:
- laser therapy (exposure to the spine with a laser);
- magnetic resonance therapy (exposure to magnetic field);
- darsonvalization (exposure to the area of damage to high -frequency pulsed currents);
- phonophoresis (administration of medicinal solutions into deep layers of the skin using ultrasound).
Manual therapy also has high efficiency.The back massage with lumbar osteochondrosis is prescribed after fading of the pain.It relaxes the muscles, accelerates blood circulation, and therefore the nutrition of tissues.It is useful to combine massage with a bath or sauna.But warming procedures are allowed only during periods of remission of the disease.
Medical physical education
Gymnastics for lumbar osteochondrosis includes exercises aimed at strengthening the muscle corset.They also increase the mobility of the spine and enhance blood circulation in its tissues.This stops degenerative processes and improves the patient's condition.
The base complex of exercise therapy includes 5 exercises:
- Twisting.Strengthen the muscles of the abdomen.Lie on your back, bend your knees and cross your arms behind your head.Then take a breath and, exhaling, lift the torso as if you want to touch the pubis.The lower back should remain pressed to the floor.
- Exercise "Cat".Relaxes the muscles of the back, unloads the spine.Stand on the karachka (on your knees, resting with your palms on the floor).Raise your head and bend your back the way the cat does when it sees danger.Then lower your head and bend your back, as the cat does when it wakes up.
- The turns lying.Strengthens the oblique muscles of the abdomen and hips.Lie on your back, cross your arms behind your head, bend your knees and press them to each other.Without disconnecting your legs, first turn them to the right, touch the floor with them, return to their original position and do the same with the left side.The torso should remain motionless.
- Burely bridge.Strengthens the muscles of the buttocks, prevents the curvature of the spine and smooth out its bends.Lie on the floor, place your arms along the body, bend your legs in your knees.Raise the pelvis and linger in this position for 5 seconds.
- Exercise for stretching the lower back and legs.Sit on the floor, stretch your legs in front of you, spread your shoulders about the width.First, lean towards one leg, pull it with your hands by the toe, feel how the muscles stretch.Stick on for 20-30 seconds.Now do the same with the second leg.
You should start with a minimum number of repetitions of exercises, gradually bringing them to a maximum (3 approach 10–20 times).They should be performed every day.This takes away no longer than 10-15 minutes, but helps to prevent a relapse of osteochondrosis.
Attention!Gymnastics is contraindicated in acute lower back pain.
Traditional medicine
At home, the treatment of lumbar osteochondrosis can be carried out by folk remedies.They will not replace drug therapy, but will become a good addition to her.In the table below, we give several most effective recipes for traditional medicine against lumbar pain.
Boil water in a pan so that strong steam comes from it.Hold a couple of burdock leaves for 10 minutes.| Means | Action | Cooking | Application |
|---|---|---|---|
| Adam root tincture | Warming, analgesic. | Grate 200 g of root on a fine grater, put in a jar and pour 0.5 liters of vodka.Put in a dark place and insist 5 days. | Rub the tincture into the lower back, put on a woolen belt on top or tie a warm scarf. |
| Compress from burdock leaves. | Anesthetic. | Boil water in a pan so that strong steam comes from it.Hold a couple of burdock leaves for 10 minutes. | Apply leaves to the place of localization of pain.Cover with plastic wrap and wrap himself.Keep 1-2 hours. |
| Pine bath | Warming, relaxing, analgesic. | Pour a hot bath, put several spruce or pine branches into the water.Add 10 drops of essential oil of any coniferous tree (cedar, pine, larch, juniper). | Take a bath lasting 10-15 minutes.Then wipe the dry and wrap himself. |
| Herbal decoction | Vitamin, anti -inflammatory, normalizing metabolism. | Put 10 g of lingonberry leaf, hop cones, thymeal and saberfish in a pan.Pour 500 ml of water, put on the stove and bring to a boil.Turn off the fire.Cover with a lid and let it brew for 1 hour.Strain. | Take 1/4 of Art.After eating three times a day.The course of treatment is 1 month.The maximum duration is 6 months. |
| Lidocaine ointment | Anesthetic. | Melt and cool 200 g of Smalz, add 75 g of bee wax, 30 g of the root of the alteum chopped to the powder state.Pour 1 lidocaine ampoule into the mixture, mix everything until smooth. | Rub into sore spots as necessary.Store no longer than 6-7 weeks. |
Attention!The possibility of using recipes of non -traditional medicine depends on what kind of lumbar osteochondrosis the symptoms are, and treatment at home should be strictly controlled by a doctor.
Surgical treatment of lumbar osteochondrosis
Surgical intervention is a radical method.Therefore, they resort to it only with the development of complications or in the case when conservative methods have not given the necessary result.Usually by this time the disease reaches 3 or 4 stages of development.
With lumbosacral osteochondrosis, treatment with an operational method usually implies a discoctomy-removal of a destroyed intervertebral disc.Less commonly removes a whole vertebra, squeezing the nerve fibers.Instead of discs and vertebrae, artificial prostheses or fragments obtained from the patient's rowing are inserted into the spine.To prevent vertebral displacement and progression of the disease, they are immobilized.For this, the spinal column is strengthened with metal plates and bolts.
The operation is carried out under local anesthesia through an incision of 3-5 cm long. To gain access to the spine, the fabrics are pushed by a special tool.From the introduction of anesthesia to suturing the wound passes from 1.5 to 2 hours.
Attention!Modern technologies allow you to carry out operations using an endoscope - a long and flexible tool, inward through an incision about 1 cm long.
Prevention of lumbar osteochondrosis
To maintain the health of the musculoskeletal system, it is necessary to take preventive measures.They will reduce the risk of osteochondrosis.And if pathological changes in the spine have already begun, they will help prevent their further development.
Preventive tips:
- If you have a sedentary work, put a roller or a special orthopedic pillow under the lower back.
- Dress the weather and do not allow hypothermia of the back and lower back.
- Do gymnastics, running or other easy sport.
- Feeling discomfort or lower back pain, see a doctor immediately.
- Refuse bad habits and eat correctly.
- Sit on hard chairs with a back.Up furniture does not support the body of the body, so the spine has to take the entire load.
- The perfect stool height is equal to the length of the lower leg.Then, when sitting, the legs will rest on the floor.If the growth is small, you can put a stand under your feet.
- The ideal depth of sitting is 2/3 of the hip length.You can less, but no more.
- Under the desktop, the legs should be spacious.
- Sit so that the back rests on the back of the chair.
- When sitting, do not tilt your head or body - keep them straight.
- In order not to tilt your head when reading, use a pupiter.
- After many hours of driving, perform a number of gymnastic exercises.
- Change the pose every 10-15 minutes, relying first on one, then on the other leg.
- If you can move in place, do it.
- Every hour, perform a few tilts back with your hands raised.During the inclination, take a deep breath.This exercise relaxes the back and belt, as well as the back of the head and neck.
- If you work standing (ironing, cook), put a bench under one leg.Its height should be equal to the height of one stage.
- In order not to bend down during home cleaning, lengthen the vacuum cleaner hose, putting forward an additional pipe.And to wash the floors, use a mop.You can wash the floors, crawling on your knees, but without leaning out of the position of standing.
- Sleep on a hard orthopedic mattress.
- Instead of the mattress, a thick solid shield (plywood plate) is suitable, covered with foam rubber with a thickness of up to 8 cm. Lay a woolen blanket and a sheet on top.
- If your legs hurt, put a towel folded into a roller under your knees.
- If you like to sleep on your stomach, put a thin pillow under it.
- If you like to sleep on your side, put one leg on the other, and your hands under your head.
- Distribute the load on both hands evenly.Frequent wearing in the same hand leads to curvature of the spine.
- If you have already diagnosed osteochondrosis, do not wear items that weigh more than 15 kg.To move them, it is better to use a bag with wheels or a cart.
- If you need to raise and transfer one heavy item, first squatting, holding your back straight.Then pick up the heaviness, rise to your feet and carry it, pressing it to your stomach.To lower the heavy object, you also need to squat down.
- Eat 3-4 times a day.
- Enrich the diet with protein: fish, low -fat meat, legumes, cottage cheese.
- Limit the consumption of sweets, baking, fatty foods.
- Include more vegetables and fruits in the diet.
- Consume products rich in calcium and phosphorus (cheese, dairy products, fish).
- Do not overeat - an excess of calories is deposited in the form of fats, which leads to the formation of excess weight.