Osteochondrosis of the spine is a chronic degenerative disease that affects the vertebrae, intervertebral discs, facet joints, ligaments and other tissues that make up the musculoskeletal system. Many people believe that only adults and the elderly are susceptible to this disease. But in recent years, this diagnosis is increasingly being made to young people and even children. If osteochondrosis is not treated, severe complications may occur.
Treatment of osteochondrosis of the lumbosacral spine is carried out in clinics where conservative methods are used to help relieve pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral, and several simultaneously. But most often it affects the lumbosacral region. This is due to the fact that the lower back bears the heaviest load when performing even simple daily activities: lifting heavy objects, walking, running, sitting. The lumbar vertebrae are the largest, so the intervertebral discs that separate them are also the largest. The lumbar region, along with the cervical region, is the most mobile part of the spinal column. This fact, together with the heaviest load, makes it a favorite "target" of osteochondrosis.
Initially, the pathology involves the intervertebral disc, which loses its elasticity, becomes "dry" and decreases in height. Their shock-absorbing function is disrupted, causing the vertebrae to move closer together. The inner part of the intervertebral disc, called the nucleus pulposus, because of its softness, begins to bulge, pushing the fibrous ring that lies around it. This is how protrusions and hernias form. They can compress the longitudinal ligaments of the spine and spinal nerve roots, causing pain.
Cause
The exact cause of osteochondrosis is unknown. But the fact that the disease is often diagnosed in representatives of certain groups shows that lifestyle has a great influence on the development of the disease. First of all, this affects people with less physical activity and sedentary work. A passive lifestyle weakens the muscular corset and reduces the mobility of the spine. Because of this, the muscles lose the ability to hold the spine in the correct physiological position, which leads to rapid wear.
The main risk factors for the development of osteochondrosis include:
- frequently lifting heavy objects;
- overweight, obesity;
- endocrine diseases, hormonal imbalance;
- poor nutrition, insufficient intake of vitamins, proteins and minerals;
- burdened offspring;
- excessive physical activity;
- back injury;
- posture disorders;
- inflammatory diseases of the joints: arthritis, arthrosis;
- congenital anomalies of the spinal column;
- Flat feet;
- pregnancy, especially multiple pregnancies.
symptoms
The peculiarity of osteochondrosis is that it can be asymptomatic for many years. At first it was a little pain and discomfort in the lower back, which disappeared on its own after a short rest. Usually, patients do not pay attention to these signs and do not consult a doctor. But gradually the intensity of the unpleasant sensation increases, and to relieve it, more rest or taking painkillers is needed.
Lower back pain with osteochondrosis is the main symptom of the pathology. Its nature, severity and location can vary - it depends on what exactly is causing the pain. Often, patients complain of pain, which increases during physical activity, standing for a long time in a stationary position, sneezing and coughing. Sometimes the pain spreads to the legs, sacrum and back. Unpleasant sensations disappear in the supine position. Often acute and sharp pain is described by the patient as a "shot in the back. "
Other common complaints:
- stiffness and tension in the back muscles;
- sensitivity is affected in the lower part of the legs with varying severity, the feeling of crawling "goosebumps" on the legs;
- limited mobility of the spinal column;
- gait changes, limp due to severe back pain or leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- throbbing in the back when bending or turning;
- urinary and faecal incontinence or, conversely, constipation and urinary retention.
Symptoms of lumbar osteochondrosis in women can be accompanied by some gynecological diseases and infertility, and in men - infertility and erectile dysfunction.
Diagnostics
Diagnosis of lumbar osteochondrosis begins with a consultation with a doctor. In addition, laboratory and instrumental examination methods are carried out to assess the condition of the spine and the body as a whole.
At the initial consultation, the doctor conducts:
- Survey.Experts explain the complaints, the time of their occurrence and the presence of contact with provoking factors: physical activity, prolonged static posture, sudden movements, hypothermia. He also reviews medical documentation - doctor's reports and previous examination results.
- Inspection. Doctors examine the skin and spine to detect visible injuries, damage and deformities. He assesses gait and limb symmetry.
- Palpate. During palpation of the spine, pain, the presence of compaction or deformity is revealed.
- Neurological examination. A consultation with a neurologist should include an assessment of limb muscle strength, sensitivity in it, as well as symmetry of tendon reflexes.
After this, the patient is referred for a more detailed diagnostic examination. To assess the condition of the body, laboratory tests are prescribed:
- general blood and biochemical tests, including assessment of inflammatory indicators - ESR and C-reactive protein;
- general urinalysis.
Intervertebral osteochondrosis of the lumbar region is confirmed by instrumental diagnostic methods:
- X-ray in two projections. X-ray images help assess the state of the bones, identify abnormalities in the development of the spine, detect osteophytes that have formed and pathological changes in the joints.
- CT. Layer-by-layer CT images allow you to study the spinal column in more detail. It describes vertebrae, bone growth and other important defects. CT scan with intravenous contrast shows the condition of blood vessels and blood circulation in tissues.
- MRI. The preferred diagnostic method, because it allows you to get a large amount of accurate information quickly and without radiation. MRI images depict the condition of cartilage, ligaments, intervertebral discs, spinal cord roots, spinal cord and other soft tissues.
Which doctor should I contact?
Diagnosis and treatment of osteochondrosis is carried out by doctors of several specialties: neurologists, vertebrologists, orthopedic traumatologists. For therapeutic procedures, physiotherapists, masseurs, acupuncturists and physical therapists are involved. Doctors of all these specialties work in the clinic. Qualified specialists carry out a comprehensive examination and prescribe an effective treatment individually for each patient.
It is important not to self-medicate, but to immediately seek help from a professional. Many people do not know why lumbar osteochondrosis is dangerous and how it can affect everyday life. If the disease is neglected, severe and often irreversible health consequences can occur. Therefore, do not delay your visit to the doctor and register for a consultation at the clinic at the first signs of the disease.
Treatment
What to do with lumbar osteochondrosis in men and women, only a qualified doctor can tell. Self-medication is strongly contraindicated - it can worsen the course of the disease. Doctors choose treatment tactics individually, taking into account the characteristics of each patient:
- age,
- stages of osteochondrosis,
- current health,
- the presence of concomitant diseases,
- period of pregnancy and breastfeeding.
Methods of treatment for osteochondrosis of the lumbar spine:
- Drug therapy.
The type of medicine, its dosage, frequency and duration of administration are chosen by the doctor. Depending on the clinical case, the following are prescribed:
Nonsteroidal anti-inflammatory drugs. They have anti-inflammatory and analgesic effects. They are prescribed taking into account the severity of pain and concomitant pathology, especially from the gastrointestinal tract and cardiovascular system.Relax the muscles. Relieves back muscle tension and reduces pain.Glucocorticosteroids. Sometimes used for severe pain and inflammation.
In the case of severe pain, it is possible to prescribe drug restrictions. This procedure involves injecting painkillers and anti-inflammatory drugs directly into the source of the pain - at a point located next to the compressed nerve. This allows you to quickly relieve pain, improve the mobility of the spinal joints and the general well-being of the patient.
- Physiotherapy.
Physiotherapy procedures improve well-being, increase the effect of prescribed drugs and accelerate tissue regeneration. For osteochondrosis, the following is recommended:
- shock wave therapy,
- magnetotherapy,
- laser therapy.
To achieve maximum therapeutic results, it is necessary to undergo a course of physiotherapeutic treatment consisting of several procedures. The doctor determines the duration and frequency of physical therapy individually.
- Massage therapy.
Massage is indicated outside the period of exacerbation. It is performed by a certified massage therapist who chooses the tactics of influencing the body taking into account the medical history. You may feel better after the first session, but several procedures are required for lasting results. One of the main advantages of therapeutic massage is its additional effect on the psycho-emotional state. During the massage, endorphins are released - hormones of pleasure and happiness.
- Acupuncture.
The essence of acupuncture is that the doctor inserts special sterile needles into certain points on the body. They act on active points in the projections of nerve endings that lead to sources of inflammation and pain. This method helps to relieve pain, relax muscles and increase the mobility of the spine.
- Therapeutic physical education (physical therapy).
Exercise therapy is indicated during the period of remission, that is, when there is no acute pain. This exercise aims to stretch and relax the spinal muscles, strengthen them and increase the mobility of the spinal joints. Therapeutic gymnastics improves blood circulation and stimulates metabolism - this improves tissue nutrition.
Regular and correct physical therapy, even at home, prevents the aggravation of the disease and the onset of pain attacks. And even in the period of acute pain, bed rest is contraindicated, it is necessary to move.
Consequences
The most common consequence of lumbar osteochondrosis is caused by a formed hernia that compresses the spinal nerve roots. As a result, the following neurological symptoms occur:
- paresis or paralysis of the lower extremities, usually the legs;
- numbness, crawling sensation in the lower part of the leg;
- disorders of the genitourinary and intestinal system.
A large hernia can compress the spinal cord, which is called discogenic myelopathy. In this case, persistent neurological symptoms develop, which sometimes lead to disability. Also among the complications of osteochondrosis, it is worth highlighting spondylosis - this is the stiffness of the joints between the vertebral arches. This disease leads to a sharp limitation of movement in the spine.
Another unpleasant complication is chronic pain syndrome, which lasts more than 12 weeks and disturbs the patient's psycho-emotional state.
Prevention
The following will help prevent the development and progression of lumbar osteochondrosis:
- regular physical activity, gymnastics;
- weight control;
- warm up every hour when working inactively and being in a stationary position for a long time;
- proper nutrition;
- visit the swimming pool;
- yoga and pilates classes;
- stop smoking and alcohol abuse;
- avoid heavy physical activity, especially heavy lifting;
- minimize stress.
A timely visit to the clinic can prevent dangerous complications of osteochondrosis. Establishing therapy in the early stages of the disease has a good prognosis for recovery. Early treatment stops the degenerative process and makes the patient's life painless and comfortable.