How to treat osteochondrosis of the lumbar spine 1st degree

Neglected condition.
Osteochondrosis of the 1st degree of the lumbar region is a degenerative disease that occurs due to flattening of the intervertebral discs. The pathology is asymptomatic in 60% of cases, and therefore goes unnoticed by humans. In other patients, osteochondrosis is clinically manifested by mild discomfort in the lower back.

Diagnosing stage 1 pathology is quite difficult. When conducting the most informative radiographic examination, the resulting images may not show specific signs of osteochondrosis.

Characteristic features of the disease

Osteochondrosis of the lumbar spine of the 1st degree is considered the starting point, after which the pathology begins to progress, involving more and more new structures of the spinal column in the degenerative process. The destructive and degenerative changes that have arisen in the intervertebral discs are still insignificant and do not have a pronounced effect on the functioning of the musculoskeletal system.

Destroyed areas of intervertebral discs usually cannot be restored, especially in elderly patients due to slow cartilage regeneration due to natural reasons. But young people, with due diligence and following all the doctor’s recommendations, can improve the condition of their discs. Their recovery processes proceed quickly, metabolism is accelerated, and enough collagen is produced in the body.

How to treat grade 1 osteochondrosis?

Step 1. You need to identify the first signs of the disease and be sure to visit a doctor.

Identify the first signs of the disease

Step 2. It is necessary to undergo all examination methods recommended by the specialist so that the doctor can make a diagnosis.

Complete all examinations

Step 3. You need to visit the specialist again, who, after reviewing the research data, will prescribe effective treatment.

Let the doctor prescribe treatment.jpg

Step 4. It is important to follow all the specialist’s recommendations.

Follow all doctor's recommendations

Step 5. You must purchase all medications prescribed by your doctor, read the instructions for their use and drink/use as recommended.

Buy medicines

Step 6. You should buy a quality mattress, preferably an orthopedic one.

Sleep on a quality mattress

Step 7. It is important to purchase furniture that is suitable for work, comfortable and ergonomic.

Clinical picture

Unlike pathology affecting the cervical or thoracic vertebrae, lumbar osteochondrosis of the 1st degree is clinically manifested even in the early stages. The lower back may experience discomfort during heavy exercise, such as after heavy lifting or intense sports training. They are very similar to muscle strain, so the patient mistakes them for physical fatigue. The accompanying symptoms of grade 1 osteochondrosis of the lumbar region may indicate that there are problems with the spine:

• the appearance of weak, nagging, aching, pressing pain in the lower back during hypothermia, overwork, a sudden change in weather or during the flu, ARVI, intestinal infections;
• a feeling of stiffness in movements began to arise when bending or turning the body;
• sensitivity gradually deteriorates, sensations of numbness and tingling, “crawling goosebumps” appear.

At the final stage of grade 1 osteochondrosis, pain in the lower back is observed more often, and its intensity increases. It is not heavy physical activity that predisposes to the appearance of discomfort, but simply a long walk or gardening.

Osteochondrosis of the thoracic region

This form of osteochondrosis is quite rare. This is due to the small amount of mobility in the thoracic region.

Each of the thoracic vertebrae is connected not only to the vertebrae (above and below), but also to the ribs (each vertebra is connected to a pair of ribs). This provides stability to the thoracic region and limits the mobility of the spine.

The openings through which the spinal nerves exit are smaller than in other sections. There is already a canal through which the spinal cord passes. Therefore, its even greater narrowing with the growth of osteophytes (bone “spikes” from the vertebrae) can lead to a violation of the blood supply to the spinal cord (spinal stroke).

As part of the thoracic roots of the spinal nerves (there are 12 of them, like the vertebrae), a large number of nerves of the autonomic nervous system pass through. Therefore, when nerve fibers in the thoracic region are infringed, in addition to disrupting the functioning of the organs to which they go:

• from the root between the last cervical and first thoracic vertebrae, part of the nerve fibers goes to the eye (pupil, orbicularis oculi muscles);
• from the first two segments - to the hands;
• from the second and the remaining ten - to the organs of the thoracic cavity (heart, lungs, large vessels), to the organs of the abdominal cavity (liver, stomach) and retroperitoneal space (pancreas, kidneys) (1),

Symptoms of dysfunction of the autonomic nervous system will also appear: arrhythmias, anxiety or fear of cardiac arrest, sweating, a feeling of heat (the so-called “hot flashes”), pallor, increased breathing.

In addition, the fourth segment of the spinal cord, which is located at the level of the 2nd thoracic vertebra, is a critical area for the blood supply to this organ. If the diameter of the spinal canal decreases, a spinal stroke (death of part of the spinal cord) will develop here more quickly than if the spinal cord is pinched in other places.

Osteochondrosis rarely develops in the disc between the 1st and 2nd, as well as between the 2nd and 3rd vertebrae (5). More often it occurs in the area of ​​6-7 thoracic vertebrae, where there is maximum backward curvature of the spine (kyphosis).

Diagnostics

Each degree of osteochondrosis has its own radiographic stage. This helps diagnose pathology, but often causes confusion among patients. The degree characterizes the characteristics of symptoms, and the stage characterizes structural and morphological changes in the spine. Lumbar osteochondrosis corresponds to both the 1st (preclinical) radiographic stage and the second. Therefore, when studying the images obtained, a neurologist may not detect destruction of the intervertebral discs. But more often, compaction of cartilaginous tissue is detected, typical of stage 2. The stability of the spine is preserved, but the enlargement of the uncinate processes of the vertebral bodies is already clearly noticeable. The intervertebral disc is minimally displaced, but the structure of the fibrous capsule has been disrupted.

X-ray of the lumbar spine.

If tissue destruction provokes even a minor aseptic inflammatory process, it can be detected using MRI or CT scans performed without the use of contrast.

Possible complications

The most serious danger of lumbar osteochondrosis of the 1st degree lies in its smooth transition to the next stage of development. If this happens, the patient is diagnosed with grade 2 pathology, which is difficult to respond to conservative therapy. In this case, not only is it not possible to partially restore the discs, but difficulties arise in stopping the destructive-degenerative process.

Any destruction of tissue, including cartilage, is often accompanied by inflammation. It is weak, sluggish, and does not interfere with the functioning of the vertebral lumbar segments. But the inflammatory process becomes the cause of a bacterial infection. And this predisposes to faster tissue breakdown.

With lumbar osteochondrosis of the 1st degree, the intervertebral bridges begin to be damaged. Such changes do not affect the patient’s well-being, but provoke the accelerated formation of an intervertebral hernia.

Pathogenesis

Regardless of the causes, degeneration of the intervertebral disc occurs when the intensity of catabolism processes (breakdown and oxidation of molecules) of matrix proteins begins to exceed the rate of their formation. One of the key points in this process is disruption of the nutrition of the intervertebral discs.

Since they, like most cartilage in an adult, do not have a direct blood supply, since they are devoid of blood vessels, the supply of nutrients to them and the removal of metabolic products occurs by diffusion during sequential compression and relaxation of the disc during movement. The main structure that provides nutrition to the disc is the endplates located on its upper and lower surfaces.

The endplates themselves are a bilayer formed by cells of cartilage and bone tissue. Accordingly, the cartilaginous side is adjacent to the disc, and the bone side is adjacent to the vertebral bodies. They are distinguished by fairly good permeability, which ensures the exchange of substances between cells, the intercellular substance of the disc and the blood vessels passing through the vertebral bodies. Over the years, especially with the negative impact of external and internal factors, the structure of the endplates changes and their blood supply decreases, which leads to a decrease in the metabolic rate in the intervertebral disc. As a result, its ability to produce new matrix is ​​reduced, leading to a progressive decrease in its density with age.

At the molecular level this is accompanied by:

• decreased rate of diffusion of nutrients and metabolic products;
• decreased cell viability;
• accumulation of cell breakdown products and altered matrix molecules;
• decreased production of proteoglycans (high molecular weight compounds responsible for the formation of new cartilage tissue cells and which are the main sources of the synthesis of chondroitin sulfates);
• damage to the collagen framework.

Basic treatment methods

Treatment of grade 1 osteochondrosis of the lumbar region is complex and long-term. Since many patients do not experience discomfort, some of them neglect medical recommendations. Therefore, they repeatedly turn to a neurologist with persistent pain in the lower back, indicating damage not only to the discs, but also to the vertebral bodies. Doctors always warn patients about a long therapeutic course. The prognosis for recovery will be favorable if several methods are used to improve blood circulation in the lumbar region. This promotes the supply of nutrients to damaged tissues, accelerating metabolism and regeneration.

Pharmacological drugs

At the final stage of grade 1 osteochondrosis, mild aching pain occurs. In most cases, eliminating them does not require the use of systemic drugs - tablets and injection solutions. You can get rid of pain using ointments or gels. They are rubbed into the lower back when discomfort occurs 1-2 times a day.

All patients take medications or dietary supplements that contain chondroitin and (or) glucosamine. Chondroprotectors stimulate the restoration of cartilage tissues that are microtraumatized during movement.

At the same time, glucosamine and chondroitin strengthen ligaments and tendons and improve the quality of synovial fluid. For grade 2 or 3 pathology, taking these drugs is useless. Neurologists also prescribe chondroprotectors to patients with grade 1 lumbar osteochondrosis, when regeneration of intervertebral discs is possible. The highest therapeutic effectiveness is characteristic of Teraflex, Structum, Arthra.

Non-drug treatment

Physical therapy helps prevent further destruction of the intervertebral discs and get rid of all discomfort in the lower back. This is the only effective method of therapy with which you can restore the previous functional activity of the spine. Thanks to daily exercises, the back muscle corset is strengthened, blood circulation in the area of ​​damaged discs is accelerated, and local immunity is increased.

Exercises for training are selected by a physical therapy doctor, based on the patient’s physical fitness and X-ray results. The first classes are also held under his supervision. The doctor shows how to perform exercises correctly so that the lumbar spine is not subjected to excessive stress.

All physiotherapeutic procedures help improve blood circulation in the lower back:

• applications with ozokerite and paraffin;
• magnetic therapy;
• UHF therapy;
• laser therapy;

Laser therapy for lumbar osteochondrosis.

• shock wave therapy.

This result can be achieved by conducting a course of acupressure, classical, and vacuum massage. Mud therapy, hirudotherapy, and manual therapy help normalize the blood supply to tissues with nutrients and oxygen.

Manual therapy for osteochondrosis.

If a person is diagnosed with lumbar osteochondrosis of the 1st degree, then no matter how strange it may sound, he is very lucky. Only at the initial stage of development, the pathology responds well to conservative therapy, and the prognosis for recovery is favorable.

Osteochondrosis of the cervical spine

The cervical region is distinguished by the following features:

• this is the only part of the spine where there is not an intervertebral disc everywhere between the vertebrae: it is absent between the 1st vertebra and the back of the head, as well as between the 1st and 2nd cervical vertebrae;
• the lateral parts of the underlying vertebrae cover the overlying vertebrae from the sides: it turns out that the latter seem to be sitting in a “saddle”;
• The edges of the cervical vertebral bodies are elongated and slightly resemble a hook pointing upward, which is why they are called “hooked.” Such a “hook” and the area of ​​the overlying vertebra do not just touch: between them there is the same joint as in the limbs: on top the articulating surfaces are covered with articular cartilage, and the articular capsule wraps the joint. These joints allow you to perform additional movements unique to this department - bending and rotation. But they “carry” additional problems - they can develop arthrosis (thinning of articular cartilage). And this is where osteophytes are formed. This is dangerous: osteophytes can compress nerve fibers or blood vessels passing in these sections.

With the development of osteochondrosis in the cervical region, when the intervertebral discs become thinner and the vertebrae themselves seem to sag, the nutrition of the joint between the “hook” of the underlying vertebra and the area of ​​the body of the overlying vertebra is disrupted. In this case, arthrosis of this joint becomes a complication of osteochondrosis.

All types of movements are possible in the cervical spinal segment:

• extension and flexion;
• bending to the sides;
• turns,

Moreover, the volume of these movements is quite large. This represents a danger in terms of the development of osteochondrosis, characteristic only of the cervical spine.

The greatest mobility is observed in the joint between the 4th and 5th, as well as the 5th and 6th cervical vertebrae (10, 11). Osteochondrosis does not affect the articular surfaces between the 1st vertebra and the back of the head, as well as the articular cartilage between the 1st and 2nd vertebrae.

The following important structures pass through the cervical spine:

• on the lateral surfaces of all cervical vertebrae, in their transverse processes, there are openings so that the vertebral artery passes here, carrying blood to the brain;
• inside the first cervical vertebra (it is very different from “ordinary” cervical vertebrae) the transition of the brain stem to the spinal cord occurs;
• Below the 1st cervical vertebra, the first cervical roots of the spinal nerves begin to emerge from the spinal cord. Next, between the two vertebrae (upper and lower) one pair of spinal nerves emerges (between vertebrae 1 and 2, 1 pair of nerves emerges, between 2 and 3 – the second, and so on). The first three of them go to the neck and its organs (thyroid gland, pharynx, larynx, trachea), partially to the eyes and ears. The fourth pair of spinal nerves goes to the main respiratory muscle - the diaphragm; the fifth to seventh pairs innervate (provide nerve signals) to the arms.

With osteochondrosis and its next stage - intervertebral disc herniation, any of these structures can be infringed. These are very life-threatening conditions. But most often, osteochondrosis develops in the lower cervical regions, pinching either the 5th, 6th, or 7th root of the spinal nerve, which is why sensitivity (tactile, temperature, vibration) and mobility of one of the arms is impaired, and pain occurs in it (with that sides where the intervertebral foramen has narrowed).