Lumbar osteochondrosis is a common disease of the musculoskeletal system. It is characterized by the development of degenerative-dystrophic processes in joint and bone tissue. Lumbar osteochondrosis implies that tissue damage occurred specifically in the lumbar and sacral area, so the patient will experience corresponding symptoms. Osteochondrosis of the lumbosacral spine causes significant discomfort to a person. It negatively affects the condition of not only the back, but also the lower extremities. About how to treat lumbar osteochondrosis, you need to check with a specialist - a neurologist or traumatologist. You should not treat this complex disease on your own or on the advice of relatives and friends. Self-medication can only aggravate the process and cause even more harm to the spine.
In Moscow, high-quality treatment for osteochondrosis is carried out at the Yusupov Hospital. The best specialists in Moscow work here, who specialize in eliminating this problem.
Degrees of osteochondrosis of the lumbar spine
The dynamics of spinal osteochondrosis distinguishes four degrees (stages):
- Grade 1 – primary occurrence of disorders in the nucleus pulposus of the intervertebral disc of the spine. The process of dehydration of the intervertebral disc occurs due to heavy loads, it is compressed, reduced, and cracks in the membrane of the fibrous ring appear. At this stage, the symptoms of osteochondrosis of the lumbar region are blurred, practically undetectable;
- Grade 2 – a noticeable decrease in the intervertebral distance caused by a decrease in the height of the discs. As a result of this, the muscles and ligaments of the spine are weakened, and unnatural mobility of the vertebrae along with the discs occurs. There is a feeling of discomfort, pain appears, especially during lifting weights and performing certain movements;
- 3rd degree – the formation of protrusions and prolapses of intervertebral discs, which are accompanied by the development of arthrosis. At this stage, signs of osteochondrosis of the lumbar spine appear more clearly. Stiffness, numbness and tingling in the lower extremities, pain in the back, lumbosacral spine or tailbone area are the main sensations of such a patient;
- Stage 4 osteochondrosis of the spine is characterized by the body’s attempt to adapt to stiffness and pain. New bone formations (growths or osteophytes) are formed, improving the fixation of the vertebra. However, they can cause pinched nerves and injure the vertebrae.
Diagnostics
If you experience back pain, you should consult a neurologist. The history is followed by an examination of the patient, during which active and passive range of motion, muscle tone, limb strength, reflexes and sensation are assessed6.
The following instrumental diagnostic methods are used:6
- magnetic resonance imaging (MRI is a method for studying the layer-by-layer structure using magnetic fields);
- computed tomography (CT is a method for studying the layer-by-layer structure using x-rays);
- in rare cases, electromyography (a method for studying electrical potentials arising in muscles);
- functional spondylography (x-ray examination of any part of the spine).
You may additionally need to consult a urologist, gynecologist and proctologist1.
Symptoms of lumbar osteochondrosis
When lumbar osteochondrosis occurs, the symptoms can be varied:
- feeling of discomfort in the spine area;
- feeling tired, irritable;
- difficult, constrained movement;
- dry skin, sweating;
- numbness of the limbs, burning sensation in the pinched area;
- muscle spasms.
Also, osteochondrosis of the lumbosacral spine is accompanied by pain of varying strength, which can radiate to the lower back, buttock and leg (radiate to the upper thigh) or to the pelvic organs.
Spinal syndrome
Spinal syndrome is a set of symptoms that occur when working at a computer. An incorrect position at the desk leads to curvature of the spine, changes in the musculoskeletal system, destruction of intervertebral discs, and subsequently to osteochondrosis. All this negatively affects the condition of the intervertebral disc and can lead to a herniated disc.
Ischemic syndrome
Ischemic syndrome occurs when the main blood arteries and vessels are compressed, which disrupts the blood circulation of the spinal column and surrounding tissues. Spinal ischemic stroke is the most severe manifestation of a violation of the spinal circulation of the spine, complicated by the formation of an intervertebral hernia.
Radicular syndrome
Radicular (compression) syndrome develops when a herniated disc of the L4-L5 and L5-S1 vertebrae occurs. Depending on what type of hernia appears (posterolateral, foraminal, etc.), one or another nerve ending can be affected.
Pain syndrome
There are several main types of pain syndromes, depending on the causes of their occurrence:
- Radiculopathy. Occurs when the radicular structures of the spine are pinched (compressed).
- Compressive myelopathy. Caused directly by compression of the spinal cord.
- Compression-vascular myelischemia. It is caused by pinching or compression of the supply blood vessels (arteries and veins) that feed the tissues of the spinal column.
- Sciatica. Pinching of the sciatic nerve.
Non-drug therapy
Physical therapy plays an important role in the treatment of lumbar osteochondrosis5,10,11. To prevent the development of the disease and alleviate its symptoms, the lower back muscles must be kept in good shape. Dosed physical activity and exercises help strengthen the muscle corset, increase range of motion and prevent complications5,11.
There are various complexes, which usually include exercises such as “bicycle”, “scissors”, lifting the body, performed in a lying position11. It is useful to do the “penknife” exercise: lying on your back, you need to press your hips to your chest and your head to your knees, “folding” like a penknife. It is recommended to do the exercise 10 times in total11. Therapeutic swimming also helps with osteochondrosis5.
It is better to carry out training under the supervision of a specialist in physical therapy, since many exercises are allowed only in the interictal period, and bending the torso forward at a certain angle can displace the disc even more5,11.
In addition to physical therapy, for lumbar osteochondrosis they use5,10:
- corsets;
- “stretching” the spine;
- manual therapy and massage;
- physiotherapy (magnetic therapy, laser therapy, ultrasound therapy);
- acupuncture.
Considering that osteochondrosis in advanced cases can lead to complications, it is important to pay close attention to the spine at any age. Prevention of disease and pain requires active action - normalizing weight, choosing comfortable shoes and regular physical activity. If the pain is severe, you should consult a doctor who will select the optimal treatment.
The information in this article is for reference only and does not replace professional advice from a doctor. To make a diagnosis and prescribe treatment, consult a qualified specialist.
to come back to the beginning
Treatment of osteochondrosis of the lumbar spine
The doctor decides how to treat osteochondrosis of the lumbar spine based on the diagnostic results. Treatment usually consists of complex therapy, which includes:
- massage and physiotherapy;
- treatment with medications;
- Exercise therapy and gymnastics.
Exercise therapy and gymnastics
Therapeutic physical training for lumbosacral osteochondrosis is aimed at strengthening the back and abdominal muscles. It improves blood circulation, helps stretch ligaments, and prevent deterioration of the intervertebral discs. All exercise therapy exercises for lumbosacral osteochondrosis are performed in a warm room without drafts. Movements should be smooth, without sudden transitions from one pose to another.
Massage
When the doctor has diagnosed lumbar osteochondrosis, massage treatment is carried out in the clinic. Massage techniques can relieve muscle tension and pain. This improves blood circulation and restores the flexibility of the spine.
Drug treatment for lumbar osteochondrosis
The purpose of drug treatment is:
- pain relief;
- elimination of inflammation;
- improving blood circulation in spinal tissues;
- restoration of cartilage tissue;
- restoration of mobility;
- relieving stress caused by severe pain.
For these purposes, anti-inflammatory (non-hormonal) drugs (diclofenac, ibuprofen, dolobene-gel), painkillers (ketanov), vasodilators, vitamins, muscle relaxants, chondroprotectors, sedatives in the form of tablets, ointments and injections are used.
Surgical intervention
Surgical intervention for osteochondrosis of the lumbar spine is performed only in severe cases of compression syndrome when all methods of conservative treatment are ineffective.
There are emergency indications for osteochondrosis of the lumbar spine:
- complete prolapse of the disc into the lumen of the spinal canal;
- acute radiculomyeloischemia;
- hyperalgic syndrome.
ethnoscience
To relieve pain and inflammation in osteochondrosis of the lumbar spine, mustard plasters, various alcohol rubs based on herbs, and ointments based on bee venom are used. These products have local (external) use.
Physiotherapy
Physiotherapeutic procedures are aimed at reducing pain, increasing the effect of drug treatment, and improving well-being during the rehabilitation period. Most often, UHF is prescribed, as well as procedures using a magnetic field or low-frequency currents, laser beams, etc.
Proper nutrition for osteochondrosis
To prevent the problem from developing and help eliminate it, the clinic doctor develops an individual diet. Basic principles of proper nutrition for osteochondrosis:
- increase the amount of fresh fruits in the diet;
- eat more greens and vegetables (tomatoes, onions, carrots, cabbage);
- include dairy products in the area;
- drink only purified and still water;
- consume more foods containing calcium (sesame, almonds);
- increase the consumption of wheat, eggs, barley, which contain a lot of proteins;
- eat more seafood.
In addition, it is necessary to maintain the level of vitamins A, B and D in the body.
At the same time, it is necessary to reduce consumption or completely abandon:
- spicy foods and foods high in salt;
- strong coffee and tea;
- alcohol, including low-alcohol drinks (beer);
- fried, dried and smoked products (fish, meat);
- products with artificial inclusions (GMO).
Proper nutrition will protect intervertebral discs from premature damage and reduce the risk of their displacement.
Disease prevention
The best means of preventing osteochondrosis of the lumbar spine are daily gymnastics and a five-minute physical break at the workplace consisting of 6-8 basic exercises, preferably swimming in the pool. All bad habits are eliminated. Particular importance is attached to the choice of mattress. It must be orthopedic, rigid and hard. Meals should be balanced and include more protein foods. The exceptions are fatty foods and mushrooms. Salt consumption is kept to a minimum.
Possible consequences
As a result of the changes that occur, the intervertebral disc becomes dehydrated, and the nucleus pulposus loses its ability to adequately distribute the loads placed on it. Therefore, the pressure inside the disc becomes uneven, and therefore the fibrous ring experiences overload and compression in several places. Since this occurs with every human movement, the annulus fibrosus is regularly subjected to mechanical pressure. This leads to unfavorable changes in it.
Also, often a decrease in the height and elasticity of the disc leads to compensatory changes on the part of neighboring vertebral bodies. Bone growths called osteophytes form on their surfaces. They tend to increase in size over time and even fuse with each other, excluding the possibility of movement in the affected SMS.
Due to the fact that malnutrition provokes damage to the collagen framework, under the influence of pressure from the nucleus pulposus, the normal structure of the fibers forming the fibrous ring is disrupted at certain points. In the absence of intervention, this eventually leads to the appearance of cracks and tears in them. Gradually, more and more fibers of the annulus fibrosus break at the site of pressure, which leads to its protrusion. This is especially facilitated by increased loads on the spine. And since the lumbar region takes on the main load during movement and any physical activity, it suffers most often.
Protrusion of the intervertebral disc without final rupture of the fibrous ring and when the size of its base is larger than the protruding part is called protrusion. If it is completely ruptured in one place or another, an intervertebral hernia is diagnosed.
When some of the fibers of the annulus fibrosus are destroyed, the pressure in the disc gradually decreases, which leads to a decrease in tension and the fibers themselves. This leads to disruption of its fixation and, as a consequence, pathological mobility of the affected spinal motion segment.
The spinal motion segment (MSS) is the structural and functional unit of the spine formed by the intervertebral disc, adjacent vertebral bodies, their facet joints, ligaments and muscles attached to these bone structures.
Normal functioning of the spine is possible only with the correct functioning of the PMS. Therefore, when pathological mobility occurs, an excessive range of movements between the vertebrae becomes possible. This creates the preconditions for the occurrence of pain and pinching of the spinal roots passing through the openings in the vertebral bodies.
Causes of radiculitis
The cause of the development of radiculitis is pathological processes occurring in the spine, namely:
- Degenerative-dystrophic processes - osteochondrosis and its complications: protrusion and herniation of intervertebral discs
- Malformations of the musculoskeletal system, accompanied by changes in muscle tone
- Poor posture, curvature of the spine - scoliosis
- Incorrect distribution of physical stress on the spinal column during a person’s professional activity (when driving a car, office workers and loaders - when they stay in one position for a long time, loaders)
- A sedentary lifestyle, in which disturbances in the blood supply to the muscles of the lumbar region gradually increase
- Improper drinking regime throughout the day and for several months
- Deficiency of vitamins and minerals leads to osteoporosis and trophic lesions of the nerve fiber
- Tuberculosis, osteomyelitis, chronic syphilis and other types of infectious lesions of the spinal cord
- Regular injuries to the vertebrae and surrounding soft tissues (impacts, sharp twists, compression when jumping, sprains of the ligaments)
- Overweight with obesity of 1-2 degrees and the presence of bad habits such as smoking, abuse of tea, coffee and alcoholic beverages