Osteochondrosis is a common disease of the spine that affects the intervertebral discs and cartilage. The cervical and lumbar spine are more susceptible to such processes. Osteochondrosis of the lumbar region can cause constant pain in the lower back and significantly complicate a person's life. When treating the disease, conservative methods are preferred; surgical intervention is carried out only in extreme cases.
Causes of lumbar osteochondrosis
Osteochondrosis is not so much a disease as 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, allowing 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 intervertebral discs undergo degenerative changes as they age, but not everyone experiences symptoms.
It is believed that osteochondrosis begins with changes in the fibrous ring, intervertebral disc and subchondral bone. The fibrous ring loses water, making it less able to withstand the daily stresses on the spine and distributing them incorrectly. Overloading 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 adjacent to the affected intervertebral disc.
Reference! According to statistics, 30% of people aged 30 to 50 suffer from some degree of intervertebral disc damage.
There are two main pathophysiological causes of pain in lumbar osteochondrosis. One of the possible causes of pain is nerve inflammation resulting from a rupture of the outer part of the intervertebral disc and protrusion of the inner nucleus. Inflammatory proteins are released that irritate the nerve tissue.
According to the second reason, the vertebrae are no longer able to effectively absorb the load due to age-related deformation. This leads to abnormal movements of the spine and causes a painful spasm of the back muscles that attempt to stabilize the spine.
The consequence of osteochondrosis can be the destruction of spinal segments, which can lead to radiculitis. Risk factors that trigger and accelerate degenerative processes in the spine are:
- Hereditary predisposition to diseases of the musculoskeletal system;
- Smoke;
- Previous injuries;
- Hormonal and vascular disorders;
- obesity;
- Muscles that are too weak and do not provide the spine with the necessary support;
- Professional activities that involve heavy physical work (athletes, loaders).
Stages of development of lumbar osteochondrosis
Disturbances of the intervertebral discs, which lead to their degeneration and destruction, occur gradually. The entire pathological process goes through several stages, according to which the stages (or degrees) of lumbar osteochondrosis are distinguished:
- The first stage (degree) is characterized by mild symptoms. Against the background of irritation of the nerve endings from the nucleus pulposus, painful sensations develop, penetrating into the cracks of the fibrous ring.
- The second stage is characterized by a displacement of the upper vertebra relative to the lower one due to cracks in the core and ring. These pathological processes, in addition to pain during movement, cause the appearance of neurological symptoms, numbness and instability of the affected area.
- The third stage is characterized by an increase in pain and the appearance of herniated discs due to a violation of the integrity of the fibrous ring. Pain, sensory disturbances and muscle weakness interfere with daily tasks. Pinched nerve roots can lead to dysfunction of the urinary and intestinal systems.
- The fourth stage corresponds to complete destruction of the intervertebral discs, they become fibrotic and osteochondral growths of the vertebral bodies lead to immobility of the spine in this section.
Symptoms of lumbar osteochondrosis
First, seek advice from specialists:
- neurologist
- Orthopedist
- therapist
The main symptom of lumbar and sacral osteochondrosis is pain. Typically, it gets worse when you sit for a long time, twist, bend your spine, or lift a load. The pain may radiate to the leg and groin and may be accompanied by a feeling of numbness and weakness. Moderate, aching, dull pain may be followed by flare-ups.
Symptoms directly depend on the stage of development of the pathology:
- In the early phase, when degenerative changes are just beginning to appear, symptoms are minimal.
- The intermediate stage, which is characterized by a weakening of the fibrous ring, can already manifest itself in pain in the lower back area.
- In the later stages, when fibrosis develops in the structures and osteophytes form, the pain becomes less pronounced, but the mobility of the spine decreases significantly.
Lower back sensitivity may be increased to touch. Characteristic stabbing pain in the buttocks and thighs as well as a tingling sensation are a sign of pinched nerve roots that occur as a result of degenerative changes in the intervertebral disc. Patients with lumbar osteochondrosis have difficulty bending forward, backward and to the side. Osteochondrosis can be complicated by herniated disc and narrowing of the spinal canal, accompanied by the appearance of additional symptoms.
Diagnosis of lumbar osteochondrosis
The diagnosis begins with taking the anamnesis, questioning and examining the patient. The specialist is interested in your complaints, your physical activity, the presence of old injuries, bad habits and cases of illness in close relatives. During a physical exam, the doctor feels the lower part of the spine, looking for tender spots, inflammation, or other abnormalities. He may also check sensitivity and carry out motor tests.
The most popular method for diagnosing lumbar osteochondrosis is X-ray examination. The image shows the presence of osteophytes, a narrowing of the joint space of the intervertebral disc or the so-called "vacuum" symptom when gas bubbles are discovered in the thickness of the intervertebral disc. Other methods used are:
- MRI shows hydration (the level of saturation with water), the shape of the discs and their height, which allows the identification of pinched nerves.
- CT scan, which allows you to examine the condition of the tissue in detail and diagnose disorders in the early stages.
- Provocative discography to determine the location of the affected intervertebral disc.
Reference! MRI is a fairly accurate diagnostic method, but it cannot detect rupture of the outer rings of the intervertebral disc.
Treatment methods for lumbar osteochondrosis
The preferred treatment for degenerative disc disease of the lumbar spine associated with chronic pain is conservative treatment with physical therapy, exercise, and medication. For patients with lumbar osteochondrosis it is recommended:
- A daily routine that includes adequate rest and sufficient physical activity;
- Regular physical exercise to strengthen muscles;
- Lifestyle adjustments, including nutritional review and weight loss.
physical therapy
Various physiotherapeutic techniques are successfully used to relieve back pain. Physiotherapy promotes regeneration processes in the intervertebral disc, stimulates metabolism and transport processes, and prevents adhesions and further damage.
Physiotherapeutic methods for treating spinal osteochondrosis include:
- Electrical stimulation. Electrical impulses help relieve back pain and improve blood flow to the affected spine.
- Ultrasound therapy. Ultrasonic waves can penetrate deep layers of tissue and help relieve inflammation and pain.
- Magnetic field therapy. Magnetic fields can improve blood circulation and metabolic processes in tissue and thus promote their regeneration.
- Laser therapy. Laser beams can help relieve pain, stimulate blood circulation and stimulate tissue regeneration.
- Ultraphonophoresis. This method combines ultrasound therapy with the use of medications that penetrate into the deep layers of tissue and help relieve inflammation and pain.
Important! Contrary to popular belief, osteochondrosis can and should be treated. Without treatment, it becomes a source of chronic pain and can lead to numerous problems, including dysfunction of internal organs.
Medication
To relieve pain that interferes with daily activities, patients are prescribed analgesics and nonsteroidal anti-inflammatory drugs. Depending on the indications, the doctor may prescribe stronger medications: muscle relaxants, steroids and narcotic painkillers. Therapeutic blocks are administered with local anesthetics and glucocorticoids to relieve severe pain.
surgery
Surgical intervention is used much less frequently for osteochondrosis of the lumbar spine. This may include a disc prosthesis or a lumbar spine fusion (which creates the conditions for the fusion of two vertebrae while reducing pain by eliminating movement in that part of the spine).
If the mobility of the spine is significantly restricted, special intervertebral spacers can be installed. For patients who do not respond to all other treatments, total disc replacement may be performed.
Treatment of lumbar osteochondrosis at home
The most effective thing you can do at home to maintain functionality and reduce pain is exercise. They increase the flow of blood, oxygen and nutrients to the spine, helping to keep the cartilage hydrated for as long as possible and keeping the spine flexible. In addition, exercise releases endorphins, which are natural painkillers.
Frequent changes in position also bring relief. Some poses help cope with an attack of pain: kneeling, leaning back, 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 relieve pain and reduce inflammation.
- Massage also relaxes muscles, relieves spasms and reduces pressure on the spine, thereby relieving pain. By increasing blood circulation in this area, metabolic processes are improved and the tissue is enriched with oxygen.
- Use of orthopedic mattresses and pillows. They help maintain the correct position of the spine while sleeping.
- Correct distribution of the load on the spine. When lifting heavy objects, you should pay attention to the correct lifting technique to avoid strain on the lumbar spine.
- Right nutrition. A balanced diet rich in calcium and vitamins helps 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 for more accurate recommendations and to assess the condition of the spine.
Which doctor should I contact for lumbar osteochondrosis?
If symptoms characteristic of lumbar osteochondrosis appear, it is recommended to consult a neurologist or orthopedist. If you suffer from back pain, you can also make an appointment with a therapist. He will prescribe the examinations necessary for the diagnosis and refer you to a specialist.
Treatment of lumbar osteochondrosis
Specialists from the nearest clinic in your city or other location are ready to understand the reasons and help manage the pain. Doctors usually have extensive clinical experience and have mastered all modern methods of treating and diagnosing osteochondrosis in women and men. Convenient location, excellent equipment and versatility of facilities are largely the focus of modern medicine, allowing you to quickly carry out any examination and restore musculoskeletal health. You can make an appointment by calling a clinic convenient for you or by filling out the online form on the website.
Prevention of lumbar osteochondrosis
Effective methods for preventing lumbar osteochondrosis are:
- Regular physical activity. Stay in good physical condition. Strengthen your back muscles. Stretching and strengthening exercises for the back help keep the spine healthy.
- Reduce stress on the spine: Avoid unnecessary stress on the spine. Use proper lifting technique when lifting heavy objects.
- Posture correction: ensure correct posture. Sit and stand straight, don't lie. For sleeping, choose an orthopedic pillow and mattress to maintain the correct position of the spine while resting. Buy quality shoes with good cushioning and support.
- Make sure you support your back by using orthopedic chairs if your job requires you to sit for long periods of time. Avoid remaining in one position for a long time. Take regular breaks and stretch your spine.
- Watch your weight. Being overweight can put additional strain on the spine.
- Avoid uncontrolled movements and back injuries. Be careful when playing sports or engaging in physical activity.
- Quit smoking as it can negatively affect the health of your spine.
By following simple recommendations, you can lead an active and fulfilling life and minimize the risk of back pain. If you already have symptoms, pain in the lumbar spine, be sure to consult a doctor for diagnosis and treatment.