Symptoms and methods of treatment of osteochondrosis of the lumbar spine.

The most common cause of back pain is the development of a disease of the musculoskeletal system such as osteochondrosis. If earlier this pathology was found mainly in older people and less often in middle age, now osteochondrosis has become much younger, it is often diagnosed in people whose age is 20-30 years.

According to medical statistics, the disease most often affects the lumbar and lumbosacral spine.

Characteristics of the disease

Osteochondrosis is a pathology of the musculoskeletal system that affects its most important component: the spine. It arises due to the fact that dystrophic changes begin to develop in the intervertebral discs.

The disease affects not only the tissue of the intervertebral discs, negative changes begin to occur in the surrounding tissues, affecting the ligaments and muscles.

The reason for the prevalence of the lumbar form of osteochondrosis is that this particular part of the spine is subject to the greatest physical stress.

With this disease, characteristic changes occur in the nucleus pulposus, which is part of the intervertebral disc. This disk performs amortization functions.

If the water exchange in the intervertebral discs is disturbed, they become thinner and their fragility increases.

Older age groups are more susceptible to the pathological process, since metabolic processes in the tissues of the intervertebral discs begin to deteriorate when they reach a certain age.

Under the influence of negative changes, the boundaries of the nucleus pulposus gradually expand, it tends to enter the intervertebral space. This usually ends with displacement of the nucleus into the spinal canal, as a result of which the nerve fibers and blood vessels are compressed and pinched.

Pinched nerves are the cause of pain in osteochondrosis. There may also be a deterioration in the functioning of internal organs.

With the progression of the pathology, the pressure force on the vertebrae increases. The body seeks to compensate for the defect and the growth of bone tissue in the spine is significantly accelerated. As a result, pathological growths, osteophytes, are formed on the vertebrae. Ultimately, this further alters the functionality of the affected column.

With advanced forms of osteochondrosis, the patient may experience paralysis of the lower extremities. Due to late access to medical care, a person can become disabled.

Causes of osteochondrosis of the lumbar and lumbosacral spine

Osteochondrosis of the lumbar and lumbosacral spine develops due to an inadequate distribution of load on the spine. If this is combined with other negative factors, the progression of osteochondrosis is accelerated, it can take more serious forms.

The disease can be caused by:

• regular heavy physical work, lifting heavy objects (people of certain professions, as well as athletes involved in weight lifting, are at risk);
• insufficient physical activity, which negatively affects the condition of the muscles and leads to a deterioration in blood circulation, metabolic processes and a decrease in the amount of nutrients entering the tissues;
• the patient is overweight, leading to the fact that the spine is constantly exposed to heavy loads;
• problems with posture and poor gait;
• the presence of congenital deformities or other defects of the spine or the entire skeleton;
• flat feet can also cause the development of osteochondrosis, since in patients with foot deformity, their arch cannot fully absorb the load during movement, which leads to increased load on the intervertebral discs;
• traumatic spinal injury;
• genetically determined bone tissue formation disorders;
• age-related changes;
• infections affecting bone tissue (tuberculosis, osteomyelitis);
• inflammatory processes affecting the bones and joints (including rheumatoid arthritis, ankylosing spondylitis);
• vitamin and mineral deficiency;
• exposure to harmful and toxic substances.

The most common cause of pathology is heavy loads on the spine in patients with incorrect posture.

Symptoms of the disease

The manifestation and severity of the symptoms of osteochondrosis depend on the stage of the disease.

There are 4 stages of the disease:

1. The first stage is characterized by the appearance of pain in the lower back (lumbago), spasms of the surrounding muscle tissues and swelling in the affected area. During this period, a change and displacement of the nucleus pulposus of the intervertebral discs begins, which causes irritation of the nerve endings.
2. In the second stage, the process of destruction of the fibrous rings of the intervertebral discs begins. The vertebrae become unstable, their mobility increases, as a result of which there is a constant tension of the neighboring muscles. Pain is noted along the sciatic nerve. At this stage of the disease, disruptions in the work of internal organs can sometimes begin.
3. During the third stage, the rupture of the fibrous rings and the release of the contents of the nucleus pulposus are observed. As a result, herniated intervertebral discs are formed. All this contributes to a further deformation of the spine (the development of scoliosis, kyphosis or lordosis can be observed). Acute pains become permanent, this is due to radicular syndrome, in which the nerve roots are compressed by fragments that have detached from the fibrous rings.
4. The fourth stage is characterized by severe deformities of the spine, pathological growths appear on the vertebrae. There may be significant pain relief, but this does not mean an improvement in the patient's condition. On the contrary, the movements of a person are very limited. Usually, patients with stage 4 osteochondrosis require a disability registry.

One of the main symptoms of the disease is pain in the lower back, which can also spread to the tailbone and lower limbs. It is divided into 3 types:

1. Lumbago: attacks of sharp pain that begin with sudden movements or lifting heavy objects.
2. Lumbodynia: severe and regular pain associated with damage to intervertebral cartilage and muscle fibers.
3. Lumboishalgia- characterized by a sensation of pain, coldness or heat in the lower back, as well as in the legs.

A person's psychological state can also cause pain.

In addition to pain, osteochondrosis is characterized by:

• feeling of weakness in the lower half of the body and legs;
• impaired tendon reflexes of the lower extremities;
• tingling, which can be felt from the lower back to the foot;
• curvature of the spine;
• with lumbosacral osteochondrosis, there is often a malfunction in the functioning of the pelvic organs (urination disorder, fecal incontinence, erectile dysfunction);
• Skin problems (dryness, peeling, bluish tinge) and changes in sweating can also occur in the lower back and buttocks.

If you find the listed symptoms, you should see a doctor as soon as possible to start treatment immediately and avoid serious consequences.

Treatment of osteochondrosis of the lumbar and lumbosacral spine

Doctor

For a patient diagnosed with osteochondrosis, the doctor may prescribe the following types of therapy (including several at the same time):

• drug treatment;
• physiotherapy procedures;
• medical massage and manual therapy;
• performing a surgical operation.

Let's take a closer look at each of these methods.

Medications are prescribed to relieve pain, fight inflammation, and enhance the regeneration of diseased tissues. It can be assigned to the patient:

• painkillers (help relieve pain);
• muscle relaxants (used to relax muscle fibers and relieve spasms);
• chondroprotectors (promote the regeneration of cartilage and bone tissue and protect them from negative influences);
• anti-inflammatory drugs;
• in case of edema, diuretics (diuretics) are prescribed;
• drugs that improve blood circulation;
• vitamin and mineral complexes.

In common forms of osteochondrosis, when conventional painkillers are ineffective, blocks may be prescribed. The doctor determines which specific drugs should be used, as well as the scheme and duration of treatment, taking into account the stage of the disease and the severity of symptoms.

It is advisable to prescribe physiotherapy together with medications to increase the effectiveness of the treatment. With osteochondrosis, the following procedures are indicated:

• laser therapy;
• magnetic resonance therapy;
• phonophoresis;
• shock wave therapy.

These treatments help relieve pain, reduce inflammation, and help repair damaged tissue. The use of a laser beam is very effective, this allows you to obtain a stable remission.

When phonophoresis is prescribed, additional topical medications are used (this method allows the medication to penetrate deep under the skin directly to the lesion). To maximize the enrichment of tissues with oxygen, the doctor may also prescribe ozone therapy.

It should be taken into account that physiotherapy is contraindicated in certain pathologies. It can not be prescribed to patients with oncological diseases, thyrotoxicosis, diabetes, tuberculosis, infectious diseases.

Massage and manual therapy can be prescribed simultaneously with drugs and physiotherapy procedures, enhancing the therapeutic effect.

These methods affect the conduction of nerve impulses and help to normalize muscle tone.

Surgical intervention is indicated only in the later stages of the disease, when other methods of treatment are useless. Surgery is required if:

• the patient experiences severe pain that cannot be controlled with medication;
• a herniated disc was detected;
• the patient is diagnosed with spinal cord compression (this leads to alterations in sensation and motor functions, from a feeling of weakness to paralysis);
• the development of cauda equina syndrome is observed.

Today, modern, high-tech and low-traumatic operations are being carried out more and more frequently, allowing the rehabilitation period to be significantly shortened. In the absence of complications, the patient will be able to move normally a few months after surgery.

Folk remedies

Traditional medicine treatments help relieve pain, reduce inflammation, and improve mobility. Here are several ways to treat osteochondrosis with home remedies.

1. You need to take raw potatoes, grate them and mix them with natural honey. The resulting mixture should be placed on your back and secured with a bandage for at least 2 hours. Applying warm boiled potatoes to the affected area also helps.
2. Grate the garlic and mix it in equal parts with the ginger. Then add a little olive oil. The resulting medicine should be rubbed on the back at night to improve blood circulation and reduce muscle tension.
3. Mix one tablespoon of menthol oil with one tablespoon of fir oil. The mixture should be rubbed on the back.
4. Take chopped pine or fir needles in the amount of ½ tablespoon for every 200 ml (1 glass) of boiling water and let it steep for 30 minutes. Drink ½ glass 2 times a day.
5. Mix a tablespoon of cranberry and mint herbs, bring to a boil with boiling water (1 glass), let it rest and strain. Drink the broth gradually throughout the day.

It is important to understand that treatment with home remedies cannot replace a visit to the doctor. Folk methods temporarily relieve symptoms, but do not completely eliminate the disease.

Also, they may not be suitable for all patients, so it is highly recommended to consult a specialist before use.

Physiotherapy exercises

Physical therapy exercises are intended to strengthen the muscles of the lower back, buttocks, and thighs, helping to relieve pain, reduce pinching of nerves and blood vessels, and restore flexibility.

In order for the exercises to be as effective as possible and not cause harm, certain guidelines should be followed:

• Exercises should be performed with clothing made of natural fabric that does not restrict movement;
• the lumbar spine during physical education should not be hypothermic;
• if you need to lie down to perform the exercise, it is better to put a round roller under the leg;
• should start exercising no earlier than an hour after eating;
• to obtain a sustainable positive effect, it is necessary to perform physical therapy exercises regularly;
• Exercises should be done smoothly, slowly, concentrating on muscle work;
• you need to control your breathing, it must be even and deep;
• It is helpful to keep a journal that includes changes from the day you started exercising.

The exercises to be performed depend on the severity of the symptoms of osteochondrosis.

In acute lumbar osteochondrosis, the spine should not be loaded, it should adhere to bed rest (preferably using an orthopedic mattress), and you can do physical education while lying on your back, repeating each movement 8-10 times. Here are some suggestions:

1. Lying on your back, place a rolling pin under your shins and bend your knees. The patient should bend the arms into a fist and flex them, and should also bend the legs at the ankle. These movements are performed alternately with each arm and leg.
2. You must alternately bend and bend the legs, moving only the knees. At the same time, the back should not move.
3. Turn each foot in turn.
4. Extend your arms and legs, then begin to bend and extend the elbows of both arms at the same time. During flexion, you should inhale and during extension, exhale. Keep your palms up.

Recommended exercises for subacute lumbar osteochondrosis:

1. With your knees bent in a supine position, rest your feet on the mattress. As you inhale, gently lift your sacrum, while your lower thoracic spine should rest on the mattress. After 1-2 seconds, gently lower the lower half of your back.
2. Lying on a mattress, while inhaling, you need to raise your head and tense your abdominal muscles. As you exhale, return to the starting position.
3. In the supine position, pull the heel towards the buttocks in a sliding motion, without lifting it off the mattress. After a few seconds, straighten your leg. The movements should be repeated for each leg separately and for both legs at the same time.
4. From a position on all fours, sit with your buttocks on your heels, sliding your hands on the mattress. Then take the starting position.
5. Get on all fours, relax your neck. Press your chin against your chest, bend your back in the lumbar area like a cat, fix this position for a few seconds. It is necessary to ensure that the head does not rise and the back maintains its accepted position.

Patients who have reached remission can perform any of the above exercises.

Physiotherapy exercises, if possible, should be performed 3-4 times a day for any form of lumbar osteochondrosis, but before you start doing them, you should definitely consult a doctor.

Preventive measures

Osteochondrosis, like most other ailments, is much easier to prevent than to try to get rid of its consequences later on. To minimize the probability of developing the disease, it is recommended:

• to ensure that the diet is healthy and balanced;
• lead an active life, move as much as possible;
• do not subject the column to excessively heavy loads;
• do exercises to strengthen your back muscles.

It is also necessary to immediately treat diseases and injuries that can lead to the development of osteochondrosis. If even minor symptoms appear that may indicate problems with the spine, you should not delay visiting the doctor.

Conclusion

Osteochondrosis of the lumbar spine is a disease that must be taken as seriously as possible to avoid serious consequences. If you adhere to a healthy lifestyle and follow the recommended preventive measures, the probability of developing pathology will be minimal.

If symptoms of the disease appear, you should consult a doctor as soon as possible. Timely medical assistance is the key to a stable remission, which allows you to stop the pathological process, preserve the patient's ability to work, and to some extent restore the previous state of the musculoskeletal system.