Spondyloarthrosis (osteoarthritis) is a common pathology of the lumbar spine. Spondyloarthritis of the lumbosacral spine is more common in older people, but it can also develop in people who do heavy physical work, are obese, or in anyone who has had a previous spinal injury.
Osteoarthritis of the lumbar spine develops in the joints that connect the segments of the spine. Each vertebra is connected to another vertebra in three places. In front of the spinal cord, the vertebrae are separated by the spinal disc. Behind the spinal cord, the vertebrae are connected by two small joints called facet joints. These joints, along with the intervertebral disc, allow the spine to move and perform movements such as bending and extension or rotation of the back.
Treatment of spondyloarthrosis of the lumbar-sacral spine can be either conservative or surgical, and the choice of treatment tactics depends mainly on the clinical picture.
Causes
Common causes of osteoarthritis of the facet joints of the lumbar spine are:
- Degenerative changes in joints and wear and tear of joints over time.
- Disc degeneration can cause the distance between vertebrae to decrease, which will increase stress on the facet joints, accelerating wear and tear on these joints.
- Backward movements of the trunk (extensions) can put pressure on the facet joints, which can lead to degenerative changes.
- A sudden fall or injury, such as a car accident, can damage the facet joints, increasing and accelerating wear and tear on the joints.
- Genetic factors may influence your likelihood of developing degenerative joint disease.
- Repetitive stress injuries, such as lifting or carrying heavy objects, can cause joint irritation and degeneration.
The healthiest food for osteoarthritis
If diagnostics have shown that osteoarthritis is developing, then it is worth including fish in your diet. The most useful are salmon, mackerel, and herring. These types are rich in omega-3 fatty acids, which can reduce inflammation, joint swelling and pain. The diet followed for osteoarthritis involves a diet rich in various foods with a jelly consistency. For example, jellied meat is very useful. This food is rich in collagen, a substance that strengthens cartilage tissue.
It is recommended to eat fresh vegetables, fruits and berries every day. They contain antioxidants that protect cells from destruction. In addition, purple and red berries contain anthocyanins. They have an anti-inflammatory effect. Vitamins A and E, found in large quantities in fresh foods, play an important role. These components reduce inflammation in the joints and improve their mobility.
It is advisable to include a maximum of dairy products (with the exception of whole milk) in your diet for osteoarthritis. They contain protein, which is easily absorbed by the body, and calcium, which is necessary to strengthen bone tissue. People on a diet for osteoarthritis of the hands, upper and lower extremities should season their dishes with olive oil. It contains heart-healthy fats and oleocanthal. This substance has some properties of non-steroidal anti-inflammatory drugs. When it enters the human body, oleocanthal inhibits enzymes that affect pain sensitivity and the development of inflammatory processes.
The diet for osteoarthritis of the ankle and other joints should include whole grains daily. They are rich in fiber. Its benefits include maintaining normal weight and reducing levels of GRB, a marker of inflammation. The healthiest whole grain foods are whole-wheat baked goods, brown rice, and oatmeal.
During the diet, patients with osteoarthritis are recommended to consume beans. Beans are very useful. It is rich in proteins that muscles need. It also contains fiber and phytonutrients. The latter help reduce the level of a special protein in the blood that provokes inflammatory processes in the body.
Symptoms
Symptoms of spondyloarthrosis of the lumbar spine will depend on which motor segment is most damaged and the degree of impact on nearby nerve structures.
Symptoms can range from mild to severe and can mimic those of disc disease:
- Back pain or radicular pain radiating into the buttock, into the leg and extending down to the back of the knee, less commonly to the front of the leg or foot.
- Pain and tenderness are localized at the level of the facet joint involved in the pathological process.
- Muscle spasm and forced changes in posture.
- Loss of movement, such as the inability to straighten, bend the body to the side, or maintain an upright position for long periods of time.
- There may be disturbances in walking and standing in cases of severe pathological process
- Sitting is usually more comfortable.
- Change in normal lumbar curvature or lordosis.
- Development of stenosis-like symptoms.
- Stiffness in the joints after a period of rest.
- Pain after excessive activity and pain relief after rest.
- There may be some swelling at the level of the pathologically changed facet joints.
- Muscle weakness in the lower extremities or symptoms of cauda equina syndrome due to the development of spinal stenosis
Diagnostics
A patient who has been experiencing back pain or stiffness for more than two weeks should see a doctor for a physical examination.
Disease history
The physician must evaluate the patient's medical history, examine symptoms, pain characteristics, and joint function, how and when symptoms began, and how they have changed over time.
The doctor also needs to find out the presence of concomitant pathology, previous treatment, family history and bad habits (for example, alcohol consumption, smoking, etc.),
Physical examination. The doctor will need to perform a physical examination to evaluate the patient's general health, muscle and bone condition, nerve conduction, reflexes, and spinal joint mobility.
The doctor also needs to obtain information about the patient's muscle strength, flexibility, and ability to perform activities of daily living, such as walking, bending, and standing.
The patient may need to perform some movements so that the doctor can understand the range of motion and determine which movements increase symptoms.
Instrumental diagnostic methods
Radiography
- a doctor may order an x-ray to see if there is injury to the spinal joints and how extensive it is. X-rays can show cartilage loss, bone changes, and the location of possible bone growths (osteophytes).
Additional diagnostic methods that may be required to exclude other causes of pain or confirm the presence of spondyloarthrosis:
PAT.
A bone scan is used to rule out inflammation, cancer, infection or a small fracture.
CT scan
can be performed to more accurately measure the degree of narrowing of the spinal canal and morphological changes in surrounding structures.
MRI.
Magnetic resonance imaging is a method that can provide a very detailed morphological picture of the spinal cord, nerve roots, intervertebral discs, ligaments and surrounding tissues.
Features of nutrition and lifestyle
Balanced carbohydrates, proteins, fats, and together the minerals, trace elements and vitamins entering the body, try not to overeat, but stick to the average daily amount of food for an adult no more than 2000 calories - all this ensures the ability to keep joints in a strong, working condition .
Osteoarthritis is a common joint disease. It worsens a person's quality of life and leads to disability. However, undesirable consequences can be avoided. After the first suspicious symptoms appear, you should immediately consult a doctor and then follow all the specialist’s recommendations. Additionally, you will need to change your diet and start following a calcium diet for osteoarthritis.
Drug treatment of the spine and joints is necessary, but it is not capable of 100% relief from osteoarthritis. Therapy should be combined with a special diet that alleviates the course of the disease.
Changing your daily diet allows you to accomplish the following tasks:
- Optimize body weight. If you manage to achieve weight loss, the load on your joints will decrease.
- Reduce the inflammatory process. Certain nutrients help accomplish this task. They are comparable in effectiveness to the components included in medications.
For example, a diet for arthrosis of the knee joints is aimed at reducing the load on the elements of the musculoskeletal system, and, accordingly, the patient’s body weight. However, you should not exhaust yourself by fasting or severe food restrictions. Such a diet should represent a complete, balanced diet, including a sufficient amount of vitamins, carbons, microelements, fats and proteins. It is important to keep the caloric content low. And with arthrosis of the shoulder joint, the primary rule is to limit the consumption of salt and hot spices as much as possible, and introduce into the diet those foods that contain a large amount of collagen - the building block for the regeneration of joint tissue (for example, fish, seafood, poultry, which has red meat, fresh herbs). In the diet for arthrosis of the hip joint, preference is given to fermented milk products, while whole milk itself is recommended to be removed from the diet; The taboo on fatty meat also applies to the menu for coxarthrosis, with the exception of products such as tongue, heart, kidneys and liver, but in moderation - these offal products will not harm the diseased joint, since they are not high in fat.
With osteoarthritis, no matter what diet you follow, you need to follow certain rules. Firstly, experts advise eating often (up to 5 times a day), but little by little. It will be easier for the body to digest food and absorb nutrients. Secondly, it is advisable to increase physical activity. As practice shows, osteoarthritis occurs more often and has an unfavorable course in obese people. An active lifestyle allows you to lose excess weight.
Treatment
Treatment of spondyloarthrosis of the lumbosacral spine is aimed at both reducing symptoms and stopping the progression of pathological processes in the joints or bones.
Most doctors take a conservative approach in the initial phase of treatment, and only then consider invasive options, but only if symptoms do not respond to conservative therapy or severe neurological signs develop.
Some of the most common treatments for lumbar spondyloarthrosis are:
- Physical therapy (PT)
is used to strengthen the muscles of the lumbar spine. Stronger muscles support the spine better and thus reduce stress on the facet joints. - Losing weight
improves symptoms simply by reducing the stress on the lumbar spine. Although weight loss can be difficult for some patients, low-impact exercise (such as swimming) combined with a low-calorie diet can often achieve the results needed to relieve pain. - Drug treatment
. Anti-inflammatory medications can reduce swelling and inflammation in the facet joint area. While over-the-counter medications such as Aleve (naproxen) or Advil (ibuprofen) can often provide sufficient symptom relief, stronger prescription medications such as Voltaren (diclofenac) and Arthrotec (diclofenac/misoprostol) are sometimes required. - The use of cold and heat
can also be effective in relieving pain in the lumbar spine. Heat can help loosen the spine before physical activity, while ice is best used after activity to reduce inflammation. - Manual therapy
. Manipulation is widely used to treat spinal diseases. Although manual therapy does not allow you to restore the full range of motion in the motor segments of the spine and restore the structure of the spine, nevertheless, manipulations can reduce pain and improve mobility. - Epidural injections
include: Injecting a steroid (cortisone or analogues) into the area of the pinched nerve. Cortisone may affect the immune system, thereby reducing localized inflammation and radicular pain.
Additional treatments include acupuncture, massage, magnetic therapy
, naturopathic remedies and other direct or indirect forms of posterior those. Although scientific evidence supporting these alternative treatments is largely lacking, most have few side effects and are reasonable options when used in conjunction with standard medical treatments.
Herbal ingredients with medicinal properties
Treatment of osteoarthritis with diet may additionally involve the use of herbal medicine. One of the useful plants is ginger. It can reduce inflammation and pain. Ginger can be added to various foods - for example, baked goods, canned food, sauces. It is most convenient to consume the plant with drinks - tea, coffee, kvass, etc.
Herbalists also advise paying attention to the following herbal components:
- Juniper cones. They are known for their anti-inflammatory properties. In order for berries to have a positive effect on the body, they must be regularly added to various food products - sauces, broths, potatoes, sauerkraut, meat dishes, marinades, etc.
- Black currant leaves. They have anti-inflammatory and analgesic properties. As a rule, a decoction of this plant material is included in the diet for osteoarthritis of the knee and other joints.
During the period of using phytotherapeutic agents, it is worth monitoring your condition. An allergic reaction may occur in the form of joint swelling and increased pain. If these symptoms appear, you should discontinue the product for a month. After this period, you can try the product again. If it causes swelling and pain again, you will have to abandon it completely.
Complications of spondyloarthrosis of the lumbosacral spine
Osteoarthritis rarely causes severe neurological dysfunction due to compression of nerve structures.
However, over time, degenerative changes can cause spinal stenosis, which means that narrowing of the spinal canal can cause compression of the spinal cord and nerve roots.
Spinal stenosis can be a complication of spondyloarthrosis.
Cauda equina syndrome is a disorder caused by compression of the nerves in the lower spinal cord by a tissue overgrowth or intervertebral disc, a rare complication of osteoarthritis that can cause serious neurological problems.
Foods that are undesirable when you are sick
When following a diet for osteoarthritis of the hip joint and other elements of the musculoskeletal system, it is recommended to avoid certain foods. Only with proper nutrition will the body’s recovery be as effective as possible. Patients should exclude from their menu:
- Fried food. Typically, such food is prepared using fat. It promotes weight gain and ultimately worsens the symptoms of the disease.
- Offal. They contain harmful preservatives, flavor enhancers and dyes.
- Sweet food. Eating foods containing sugar too often disrupts collagen synthesis in the human body. This has a negative impact on the joints.
- Strong tea and coffee. Scientists believe that enzymes and tannins contained in such drinks have a negative effect on joints.
- Whole milk products. They contain arachidonic acid. It stimulates the production of substances that provoke inflammatory processes and destroy tissue.
- Alcoholic drinks. Alcohol, affecting the body, provokes an exacerbation of the disease. In addition, alcohol can interact with the medications you take and reduce their effectiveness.
Do not get carried away with egg yolks and red meat. These products, like whole milk, contain arachidonic acid, which has a negative effect on joints. In a diet for osteoarthritis, limit salt intake. This ingredient causes water retention in the body. This causes swelling and inflammation. However, salt cannot be completely excluded from the diet.
It is not advisable to set a diet for yourself, because without special knowledge it is impossible to make your diet as safe and balanced as possible. It is recommended to contact specialists. The doctors of our clinic seek an individual approach to each patient. They develop diets for deforming osteoarthritis, taking into account the health status of a particular patient, the characteristics of his existing diseases and the presence of an allergic reaction.
Surgery
In cases of severe spondyloarthrosis that cannot be treated conservatively, surgery may be indicated.
Generally, surgery is considered if the patient experiences some of the following symptoms:
- Increased radicular pain
- Increased pain or nerve irritation
- Associated disk damage
- If degenerative changes in the facet joints lead to compression of the nerve roots, then radicular syndrome occurs. This causes radicular pain, weakness, and stenosis-like symptoms. In this case, surgery may be indicated to release the nerve root and remove excess degenerative tissue that is putting pressure on the root. One such procedure is called a foraminotomy. In addition, an operation such as vertebral fusion (spinal fusion) is used.
- Vertebral fusion is a surgical procedure used to eliminate movement between adjacent vertebrae. When all other treatments fail to provide relief, spinal fusion may be a reasonable option for treating severe spondyloarthritis.
Self help
- Self-medication is important for pain caused by spondyloarthritis because pain may increase or decrease over several days.
- Experts have found that even if there is pain, staying in bed for a long time is not advisable. Therefore, it is recommended to continue normal physical activity.
- However, you should avoid anything that could aggravate the condition, such as lifting heavy loads.
- Some people benefit from applying heat or ice to treat back pain.
- Sleeping with a pillow between your legs can be beneficial for lower back pain. An orthopedic mattress can also provide good support.
Nuances and features of obtaining disability with spondyloarthrosis
For the first five years, the disability group is reviewed annually. This is preceded by mandatory hospitalization and repeated MSE. At such repeated examinations, issues of maintaining the group, increasing or decreasing it, the effectiveness of the treatment measures taken, etc. are resolved. In the event of no effect from treatment or progression of clinical signs of spondyloarthrosis, the group is established indefinitely.
It is not so easy to obtain a disability group, despite the presence of generally accepted criteria. In addition to medical aspects, there are also social ones: the financial security of the patient himself, as well as the relatives around him, the ability to undergo expensive treatment methods, living conditions, etc. These nuances can delay the receipt of disability over time or reduce its group. Also, in such cases, an indefinite group is reluctantly issued, even after 5-7 years of steadily progressing disease.
There is another, unspoken feature of older people. They are accustomed to overestimating their capabilities and at the commission they tell that they cope with all household chores, or that they can walk outside on their own, without specifying what is included in these actions. Most often, this happens unnoticed by the patients themselves, when hours-long walks gradually turn into sitting on a bench near the house, and the commission doctors do not know about it. Therefore, it is strongly recommended that when receiving a disability group and applying for social assistance, you do not exaggerate or minimize your condition; it must be fully consistent with instrumental research methods.
It is also important throughout life to constantly issue sick leave for the underlying disease. The number and duration of exacerbations play an important role in obtaining disability.