People with the osteochondrosis of the lumbar column always avoid sudden movements, carefully lean and turn to the sides, feel slowly, get up.Therefore, they try to avoid lower and sharp back pain, forcing them to freeze in a body position.Osteochondrosis is also manifested by creaks, clicks, mobility limitation.Its treatment is more conservative, but with serious damage to discs and vertebrae, surgical intervention is required.
What is the osteochondrosis of the lumbar column?
Lumbar osteochondrosis is a degenerative-dystophical pathology, which initially affects intervertebral discs.Due to insufficient nutrient intake, they lose the ability to retain moisture.The regeneration processes slow down, the discs become plans, fragile.The distance between adjacent vertebrae is reduced, therefore, bone tissues grow to stabilize the lumbar segment affected by osteochondrosis.Osteophytes are formed: bone growth, with the displacement of which soft tissue structures, nerve roots, blood vessels are injured.
Stages of pathology
The stage of osteochondrosis is the stage of disease development, which is characterized by certain destructive changes in the discs and bodies of the vertebrae.It is established using an X -Ray exam.In the resulting images, the specific signs of destruction of the vertebral structures are clearly visible.Each stage corresponds to the severity of osteochondrosis, a set of symptoms.The greater, the more difficult the disease lends itself to conservative treatment.
| Lumbar osteochondrosis stage | X -ray characteristics and clinical manifestations |
| First (preclinical) | There are no signs of osteochondrosis in radiographs.From time to time there are uncomfortable sensations in the lower back after physical effort or long -term stay in the legs |
| The second | There is a rectification of lordosis, less frequently: the scenes of the vertebral bodies, the deformation of the semi -unes processes.The height of the discs is reduced slightly.Painful sensations appear more frequently, their duration increases |
| The third | The subchondral sclerosis of the closing plates, the damage to a large number of semi -unes processes and a moderate decrease in the album height is observed.In addition to pain in the lumbar region, the clinic contains a crunch and rigidity of the movements |
| Four | The semi -unes processes are rejected out and subsequently.There is compensatory growth of bone tissues, the formation of multiple osteophytes.The pain occurs when it moves and at rest |
Causes of the disease
The causes of the development of osteochondrosis are often increased loads in the lumbar column.The discs are constantly microtrauma, they do not have time to recover in a timely manner.A significant part is gradually damaged, launching the deformation of the bone bodies of the vertebrae.Such pathological conditions are also able to cause the destruction of the lumbar segment:
- Congenital or acquired abnormalities: flat feet, scoliosis, kyphosis, feet valge deformation, TBS dysplasia;
- Systemic pathologies: rheumatoid arthritis, sclerodermia, red lupus;
- Endocrine and metabolic disease, diabetes mellitus, hyperthyroidism, obesity;
- Previous lesions: subluxation of the vertebrae and their fractures, damage to the spinal cord;
- Circulatory disorders, even at the bottom of a sedentary lifestyle.
One of the main causes of osteochondrosis is the natural aging of the body.After 50 years, the recovery processes decrease, collagen production decreases, the state of the ligaments worsens.
Signs and symptoms characteristic of the disease
In the initial development stage, osteochondrosis does not appear clinically.A person takes a weak pain of the lower back for muscular survival after a working day and does not consult a doctor.But the severity of the symptoms is increasing slowly, soon a crunch with inclinations and turns of the case, sensitivity disorders and rigidity bind in pain.
Syndrome
This is the name of the defeat of the spinal roots, which leads to motor, vegetative and severe disorders.Rotor syndrome develops with 3-4 gravity osteochondrosis.In these stages, an intervertebral hernia is formed, compressing spinal roots.The pathology is done according to the type of lumbago, low back pain and lumbar -Ilgia.In addition to severe pain, root syndrome is characterized by sensations of numbness, tingling, chicken, decrease or complete skin tracking absence of sensitivity.
Ischemic syndrome
In the last stages of the course of lumbar osteochondrosis, it is possible to compress large blood vessels.The pelvic organs stop receiving a sufficient amount of nutrients, which leads to a violation of its operation.The brain brain trophy is also upset, a neurological deficiency develops: an intermittent limp appears, temperature, sensitivity to pain falls.
Vertebrate syndrome
As a result of reducing the distance between the adjacent bodies of the vertebrae, the growth of the bone tissues, the lumbar vertebral segments are gradually deform.The situation is aggravated by the constant compensatory stress of the back muscles with its subsequent atrophy.Pathologically changes the march and position of a person, even due to the inappropriate redistribution of charges.The probability of involving other parts of the column and the joints of the legs in the destructive-depressive process increases significantly.
Pain syndrome
In the lower part of the back there is a great sciatic nerve formed by sacred spinal roots.When it is infringed with hernial protrusion, bone growth, spasmodic muscles, Ishias occurs, a typical lumbar osteochondrosis symptom.There is an acute pain that extends along the sciatic nerve to the hips, the knees, the lower legs (lumbar ilgia).Another specific characteristic of the pathology: lumbago, or "shots" in the lower back after a strong inclination or turn, hypothermia.
Diagnostic methods
When making a diagnosis, the radiographic images taken in two projections are more informative.To study the affected lumbar segment in more detail, a magnetic resonance is performed.The study allows you to evaluate the condition of the spinal cord, soft tissue structures, blood vessels, nerve roots.It is possible to determine the degree of damage to nerve trunks using the potential caused, electronography, electromyography.To aim the examination of the affected discs, the discography is used.
How the treatment is carried out
A comprehensive approach to lumbar osteochondrosis is practiced.The treatment aims to eliminate pain, restoring the volume of movements, avoiding the spread of pathology to healthy discs and vertebrae.
Drugs
The use of non -steroidal anti -inflammatory drugs, glucocortosteroids, muscle relaxants allows you to get rid of low back pain.In therapy, medications are used to improve blood circulation.Patients should receive Vitamins from Group B, Condroprotectors.
Medical Physical Education
This is the most effective and affordable treatment for osteochondrosis.After 1-2 months of daily treatment of physiotherapy exercises, the muscles not only of the lower back, but the whole back improves the posture, accelerate the blood supply to the damaged structures of the connective tissue.LFK doctors recommend that patients recommend slow and soft turns and torso inclinations, shameless squats and hits.
Massage
Patients with lumbar osteochondrosis show all kinds of massage: empty, acupuncture, connective, segmental.But the greatest demand is classic.During the session, the massage therapist performs the main massage movements: caressing, rubbing, kneading, vibration.The objectives of the procedures are to eliminate muscle cramps, improve blood circulation in the affected segment and strengthen skeletal muscles.
Physiotherapy
In an acute and subacute period, patients are prescribed by electrophoresis or ultra -phorephoresis with glucocortic, anesthetics, group B vitamins. In the remission stage, laser therapy, magnetotherapy, stressed wave therapy and UHF therapy are often carried out.Ozkeritoling, paraffin, hirudotherapy, mud, radon, hydrogen sulfide baths are also used.
Surgical intervention
The main indication for surgical intervention is the infraction of the spinal cord with hernial protrusion.During the operation, intervertebral hernia is eliminated, the decompression of the spinal channel is carried out.The most used surgical intervention methods for lumbar osteochondrosis are microdectomy, puncture vaporization or laser reconstruction of the disc, implant installation, stabilization of the vertebral segment.
Traditional medicine
After the main therapy, the achievements of the stable remission in treatment, homemade ointment, herbal teas, compresses, oil and alcohol rubbing are used.Popular remedies do not affect the cause of osteochondrosis, therefore, they are used to eliminate weak and painful pain, gravity in the lower back after hypothermia, a sharp change in the climate or a greater physical activity.
The consequences of the lack of treatment
The development of almost all complications of lumbar osteochondrosis is caused by formed intervertebral hernia.Discogenic myelopathy is especially dangerous, which is not always a surgical treatment.It is manifested by pelvic disorders, including defecation, urine disorders.Osteochondrosis complications also include Rooser's syndrome, a common cause of acute and penetrating low back pain.
Prevention and prognosis measures
The prognosis is favorable in the diagnosis of 1-2 grades of gravity.It lends itself well to conservative treatment, and in young patients it is even possible to partially restore the tissues of the intervertebral discs.With the development of complications, the forecast for complete recovery is less favorable.
The prevention of the osteochondrosis of the lumbar column is to control body weight, the exclusion of excess loads, the timely treatment of endocrine metabolic diseases.Neurologists and vertebrologists recommend visiting the pool, participating in watercolors, Pilates, Scandinavian walk.