Osteochondrosis is the most severe form of degenerative-dystrophic damage to the spine, which is based on damage to the nucleus pulposus of the intervertebral disc, with subsequent deformations of the bodies of adjacent vertebrae, intervertebral joints, disorders of the ligamentous apparatus, and involvement of the nervous system and blood vessels in the pathological process.
One of the most common forms of osteochondrosis is lumbar osteochondrosis , or, more precisely, the lumbosacral spine. Many people - both men and women - are familiar with back pain in the lumbar region, sacrum, and lower extremities, caused by various types of lumbar osteochondrosis and its complications. Among the causes of temporary loss of ability to work and disability, this disease occupies one of the first places.
The course of the disease is chronic, usually with periods of exacerbations. Most often, exacerbations of lumbar osteochondrosis are provoked by lifting and carrying heavy objects, hypothermia, stress, and injury.
What is osteochondrosis of the lumbosacral region?
With age, due to a number of reasons, degenerative-dystrophic changes are diagnosed in the spine. The lumbar vertebrae are more susceptible to them. The cartilage of the intervertebral discs becomes denser and changes its structure, deforming the spine, in particular at the junction with the sacrum.
Following cartilaginous structures, bone tissue is involved in the pathological process. As a result, the entire spinal motion segment is affected. Osteochondrosis of the lumbosacral region can lead to the formation of disc herniations and destruction of the vertebrae, making a person disabled.
Probable causes
Among the probable causes of the pathology, it is customary to highlight:
- increased or insufficient load on the muscles due to non-physiological factors;
- violation of metabolic processes;
- suffered injuries, in particular not only acute, but also chronic microtrauma received in the process of playing sports;
- dysfunction of the musculoskeletal system;
- genetic predisposition to pathological processes occurring in bone and cartilage tissue;
- poor posture;
- lack of physical activity;
- features of human professional activity.
It is worth noting that uneven distribution of load along the spinal column can cause a deterioration in the quality of blood supply to the intervertebral discs, which sooner or later leads to their degeneration and final destruction.
Causes of lumbosacral osteochondrosis
The etiology of the disease is not fully understood. Osteochondrosis of the lumbosacral spine develops under the influence of the following reasons:
- burdened heredity;
- injuries (bruises, fractures, etc.);
- natural aging and “wear and tear” of the elements of the lumbosacral zone;
- sedentary lifestyle, prolonged static loads on the spine;
- poor nutrition, with insufficient intake of microelements, vitamins and fluids;
- increased load on the lumbosacral region (professions associated with physical labor or sports, walking in high heels, and so on);
- obesity;
- "metabolic diseases";
- autoimmune diseases, in which aggression is directed at the cells of the connective system;
- infections and intoxications;
- any factors causing a lack of innervation and blood supply to the lumbosacral spine;
- bad ecology;
- emotional overstrain (stress);
- pathology of the musculoskeletal frame (flat feet, osteoporosis, rickets, etc.).
The lumbosacral area experiences enormous stress in women during pregnancy and childbirth. Osteochondrosis often develops in professional athletes who abruptly stop training.
Symptoms
At first, the disease may not manifest itself. Later, symptoms of lumbosacral osteochondrosis appear:
- pain of varying nature and intensity (from periodic aching painful sensations to acute attacks when a person cannot move or take a step), with frequent irradiation to the legs, groin area and lower abdomen;
- sensitivity disorders of varying severity (numbness, “crawling”, and so on);
- abnormal functioning of the pelvic organs (bladder, reproductive system, rectum and others);
- vegetative-trophic changes;
- muscle weakness, movement disorders, up to paresis and paralysis of the lower extremities.
In advanced cases of osteochondrosis of the lumbosacral region in men and women, infertility and serious diseases of the internal organs are diagnosed.
Orthopedic devices and prevention
Some patients are advised to wear orthopedic corsets, which help reduce the load on the spine. They differ in the degree of rigidity and design features, so your doctor will help you choose a specific model. He will be able to accurately determine whether a particular patient needs a bandage or not.
But absolutely everyone who has been diagnosed with lumbosacral osteochondrosis is recommended to change their mattress and pillow to orthopedic ones. If you have osteochondrosis, you should sleep on a medium-hard mattress that maintains the physiological curves of the spine, and the right pillow will help support the cervical spine.
Thus, lumbosacral osteochondrosis is a fairly common problem, which over time can lead to a number of undesirable consequences, including the need for surgery or disability. Therefore, when symptoms of the disease appear and after its diagnosis, it is important to immediately begin treatment for lumbosacral osteochondrosis in Moscow under the guidance of an experienced neurologist according to an individually designed program.
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Stages
Osteochondrosis of the lumbosacral spine includes four standard stages:
- The nucleus pulposus inside the disc moves atypically, causing compression and stretching of individual zones of the annulus fibrosus.
- Defects form in the annulus fibrosus and the entire spinal segment becomes unstable.
- A disc rupture occurs with the formation of an intervertebral hernia and the development of an inflammatory process. Nerve endings and blood vessels may be pinched or injured.
- There is ossification of the spine, inflammation of small joints connecting the vertebral bodies of the lumbosacral region with the processes and other compensatory and pathological changes.
In the fourth stage of the disease, complete immobility (fixation) of the vertebrae relative to each other may develop.
Types of intervertebral hernias
A bulging intervertebral disc can form both in the back of the spine and on the inside. Based on this, anterior and posterior (dorsal) hernias are distinguished. The former do not pose any particular danger and almost never lead to disruption of a person’s well-being. The latter protrude into the spinal canal, where the nerves pass, and can cause severe neurological complications.
There are several types of dorsal hernias:
- median;
- paramedian;
- foraminal;
- circular (diffuse).
The final stage of development of each of them is sequestration, i.e. separation of the prolapsed part of the nucleus pulposus. Sequestered hernias can move along the spinal canal and cause spinal cord stenosis, which is accompanied by severe neurological disorders. Such protrusions must be immediately treated surgically.
Also, all hernias can be divided into 3 categories depending on their size:
- small – less than 5 mm;
- medium – reach 5 – 7 mm;
- large - more than 8 mm.
Median
The protrusion is located precisely in the center of the spinal canal and can cause pain in the lower back, radiating to the back of the thighs and legs. If the formation is large, disturbances in the control of urination processes may occur, and the sensitivity of the legs may decrease, which leads to paresis or paralysis.
Paramedian
They form on the left or right side of the spinal canal, which leads to the development of unilateral symptoms, as well as burning pain in the perineum, numbness of the groin area and significant difficulty in urinating or defecating, even if there is a strong urge.
Foraminal
Localized in narrow openings formed by the vertebral bodies and their articular arches. Nerves run through them. Therefore, even the smallest hernias can provoke severe neurological disorders and severe pain.
Diffuse
In such cases, the entire posterior surface of the intervertebral disc protrudes and, as it grows, is able to fill the entire space of the spinal canal, the size of which usually does not exceed 1.5–2 cm. A hernia of this type is characterized by the presence of pain even in a state of complete rest, as well as the presence of sensation tingling in the legs and weakness, which can ultimately lead to loss of the ability to move and control over urination and bowel movements.
Methods of treating lumbosacral osteochondrosis
Therapy always begins with a set of conservative measures. Treatment of osteochondrosis of the lumbosacral spine is based on 4 areas:
- local impact;
- systemic drug therapy;
- vertebroneurological techniques;
- reflex methods.
Therapeutic tactics for osteochondrosis of the lumbosacral region are always based on the individual characteristics of the patient. It usually includes therapeutic exercises, water exercises, massage, spinal traction, physiotherapy and pharmaceuticals. In case of severe intractable pain, blockades are indicated. In severe cases, surgical intervention is resorted to.
Drug treatment
The medicinal treatment procedure is prescribed by a doctor. Thus, treatment of osteochondrosis of the lumbosacral region may include several types of local and systemic drugs. In the acute period, the most important is spinal immobilization and pain relief. They always begin to relieve a pain attack with non-steroidal anti-inflammatory drugs and analgesics. Additionally, muscle relaxants, antispasmodics, B vitamins, diuretics and other groups of drugs can be used.
During remission of osteochondrosis of the lumbosacral region, chondroprotectors, agents that improve tissue trophism, vitamin and mineral complexes, etc. are used. Preventive courses help prevent exacerbations.
Surgical treatment
If lumbosacral osteochondrosis does not respond to conservative therapy and continues to progress, surgical intervention is recommended for the patient. The extent of the operation will depend on the severity of the existing changes and the presence of complications. In advanced cases, the affected areas of the spine are replaced with implants.
Folk remedies
Osteochondrosis of the sacrolumbar spine in the early stages can be treated not only with traditional methods, but also with the use of folk recipes. At home they often use:
- compresses;
- wraps;
- rubbing;
- baths;
- teas with medicinal herbs.
Compresses with sea salt, honey, radish, horseradish, red pepper and natural healing mud have proven themselves well.
But still, for osteochondrosis of the sacro-lumbar spine, the best option would be if a person makes an appointment with a doctor.
Diet and exercise therapy
Almost always (with the exception of complicated osteochondrosis), treatment of the sacral spine includes physical exercise and proper nutrition. With concomitant obesity, the diet will be aimed at weight loss. And with food, a person should receive in sufficient quantities all the necessary vitamins, microelements and nutrients. The role of vitamin D, phosphorus and calcium is especially important. In order to have a positive effect on cartilage cells, meat broths, fish dishes, and jellied meat are recommended.
A set of exercise therapy exercises is developed by a specialist for each specific patient. Its main tasks are:
- strengthening the muscles around the affected segments of the lumbosacral area;
- spinal traction.
After training, a therapeutic massage will be useful.
Lumbar osteochondrosis: symptoms and treatment of exacerbation
Exacerbation of lumbar osteochondrosis can be triggered by sudden movement, lifting weights, or hypothermia. Acute pain in lumbar osteochondrosis can increase gradually or appear suddenly. Most often, exacerbation of lumbar osteochondrosis is accompanied by acute severe pain. During an attack, muscle spasm occurs in the lumbar and thoracic spine, which prevents the movement of the back to prevent increased pain. Pain in the acute period spreads to the buttocks and leg, which are connected by nerve fibers to the affected area of the spine. A person is forced to take a certain position and not change it (usually a horizontal position with the affected leg bent). Even minor movements, such as coughing, can cause another attack of pain.
An exacerbation of lumbar osteochondrosis, treatment of which must be started immediately, can last several days or weeks (depending on how quickly adequate therapy was started). At the Yusupov Hospital, treatment of acute osteochondrosis is performed immediately after the patient’s treatment. The hospital's emergency department is open 24 hours a day, so the patient can receive help at any time. To relieve acute pain, blockades are performed - the introduction of an analgesic into the affected area, which contributes to a significant improvement in the condition. After eliminating the acute period, the main course of treatment begins.
Preventive recommendations
Having studied the symptoms and treatment of osteochondrosis of the lumbosacral spine, you need to familiarize yourself with preventive measures. They include:
- nutritious nutrition with a high content of nutrients, minerals and vitamins;
- adequate physical activity;
- exclusion of injuries and damage to the spine, as well as any unfavorable factors;
- treatment of chronic foci of infection in the body and diseases that negatively affect the musculoskeletal system.
Knowing what osteochondrosis of the sacral spine is, symptoms and treatment in women, as well as preventive measures, is especially important when planning pregnancy and gestation.
Diagnostic features
Only a specialist can make a diagnosis after a thorough examination.
It is important to remember that the symptoms of a degenerative-dystrophic disease are nonspecific, which implies the need to consult a doctor who can rule out the presence of other ailments, in particular various neoplasms that can provoke similar symptoms.
In order to determine the localization of the pathology, an x-ray examination is prescribed. Clarification and confirmation of the presumptive diagnosis is carried out using magnetic resonance imaging, which provides high-quality images of each layer of the spinal column.
A wide range of nonspecific symptoms often leads to a false diagnosis and, as a consequence, incorrect treatment of lumbar osteochondrosis. Based on this, we can come to the conclusion that it is important to carry out a comprehensive diagnosis by visiting different specialists, including: vertebrologist, neurologist, nephrourologist, gastroenterologist and surgeon.