Osteochondrosis of the lumbar spine

One of the most common diseases today isosteochondrosis of the lumbar spine. Both men and women equally often turn to doctors with this disease.

At least once in our lives, each of us has experienced pain in the lower back, sacrum or lower extremities. We often unknowingly call this type of pain "pinched nerve in the lower back. "

Causes of lumbar osteochondrosis

According to research by doctors and scientists, the main cause of osteochondrosis of the lumbar spine is upright posture. However, not all people suffer from osteochondrosis. Provoking factors that accelerate the development of the disease are: metabolic disorders, physical inactivity, injuries, excess weight, improper lifting of weights.

The source of pain in osteochondrosis is pinched nerve roots, which occurs after protrusion of the intervertebral disc and narrowing of the intervertebral gap. This deviation is formed when nutrition deteriorates, the natural processes of oxygen and lymph exchange in the tissues of the intervertebral discs are disrupted. As a result, the shock-absorbing capacity of the intervertebral discs decreases, and the nucleus pulposus of the disc gradually decreases and dries out.

From an anatomical point of view, lumbar osteochondrosis is a process of transformation of cartilage into bones, resulting in excessive pressure on the nerve roots that extend from the spinal cord. This change causes pain. Overgrowth of bone tissue occurs due to deterioration of nutrition of the intervertebral discs, loss of fluid and disturbances in structure and functioning.

When the protrusion of the intervertebral disc during the development of osteochondrosis of the lumbar spine becomes more serious, it provokes the development of lumbar protrusion and lumbar disc herniation due to rupture of the fibrous ring.

The pain syndrome is formed due to pinching of the spinal nerve in lumbar osteochondrosis and is called lumboischialgia. This symptom is accompanied by numbness of the lower extremities. Depending on the nature and location of the pain, the disease can be divided into sciatica and lumbago. Inflammation of a nerve due to its pinching is called radiculitis. Methods of treating radiculitis with painkillers, in fact, are only the elimination of symptoms, and are ineffective, because such treatment does not affect the true cause of the disease, namely degenerative processes in the intervertebral discs. To eliminate pain and take preventive measures to prevent complications, you need to undergo a comprehensive treatment course to activate restoration processes in the tissues of the discs, normalize the height and physiological parameters of the intervertebral discs.

Symptoms of osteochondrosis of the lumbar spine

One of the signs of osteochondrosis is compression of the spinal nerve roots by the protruding nucleus pulposus of the intervertebral disc. This compression occurs in the epidural space, which is a kind of container for the spinal roots. Osteochondrosis of the lumbar spine is manifested by the following symptoms that correspond to a compressed root:

• L1 and L2 – loss of sensitivity in the area of the "rider’s pants", namely in the groin area and inner thighs. Pain can occur in both legs at once if lumbar osteochondrosis is complicated by the development of a hernia.
• L5 – shooting pain, decreased sensitivity in the lower back and sensitivity of the thumb, as well as decreased ability to flex the finger.
• S1 – shooting pain, decreased sensitivity of the lower leg and outer thigh, pain in the foot from the little toe to the fourth toe. Often when this root is damaged, the Achilles and plantar reflexes are lost.
• Damage to the Deproge-Gotteron artery - in the chronic course of osteochondrosis, paralysis of the lower leg and buttocks may occur, and sensitivity may disappear in the anogenital area.
• Simultaneous damage to the L5, S roots and the Deproge-Gotteron artery causes the syndrome of "paralyzing sciatica", loss of pelvic and motor functions.

Osteochondrosis of the lumbar spine can cause protrusions and hernias due to significant loads on this part of the spine. It is these complications that develop very quickly, so it is very important to treat them in a timely manner. Do not delay your visit to a vertebrologist, undergo a full examination, and seek qualified help at the first symptoms of lumbar osteochondrosis.

Complications of osteochondrosis of the lumbar spine

Compression-vascular ischemia can be considered a complication of lumbar osteochondrosis. This pathology develops due to impaired blood supply to the spinal cord, reduction of intervertebral openings for vessels and arteries, as well as narrowing of the peripheral structures of the vertebrae. The reason for the development of this pathology is flattening of the discs, excessive mobility of the spine, weakened ligaments, the formation of osteophytes and neoathrosis. Permanent injury and pressure on a pinched vessel or artery occurs due to any movement of the spinal column that affects the damaged area. In addition, a reflex narrowing of the vessel that passes through the clamped opening of the canal may develop. This effect is called "narrow bed".

Vertebrologists identify another serious complication of osteochondrosis of the lumbar spine. Compressive myelopathy is a spinal cord disorder that occurs due to narrowing of the spinal canal. Depending on the location, symptoms and severity of the pathology may vary. Most often, the course of the disease is characterized by episodicity - after an attack there is a period of remission.

Lumbar osteochondrosis can be complicated by a herniated disc TXII-L1, which puts pressure and provokes damage to the S1-S2, L2-L-4 segments of the spinal cord. A patient with this complication feels pain in the lower back, lower leg, back of the thigh, as well as weakness in the legs. The gluteal and calf muscles gradually become hypotonic and hypotrophic, the Achilles and plantar reflexes fall out, and foot paresis forms. The back and outer surfaces of the foot and lower leg are characterized by reduced sensitivity or its complete absence.

If a LI-II disc herniation develops, in which excessive pressure on the coccygeal segment S3 increases, osteochondrosis of the lumbar spine has the following symptoms: disruption of the pelvic organs, fecal and urinary incontinence, constipation, loss or decrease in sensitivity of the anogenital area, development of bedsores, anal prolapsereflex.

"Cauda equina syndrome" develops when the nerve roots are compressed from the first lumbar vertebra and below. An experienced vertebrologist notes that this syndrome most often develops in patients with congenital narrowness of the spinal canal. The "cauda equina" is a bundle of nerve roots that contains the terminal roots of the spinal cord from the first segment onwards. The name arose from its resemblance to a horse's tail. Diagnosis of this syndrome largely depends on the presence of excruciating pain of a radicular nature. It is this feature that distinguishes cauda equina syndrome from other complications in which there is no acute pain.

Cauda equina syndrome is characterized by intense pain in the sacrum and lower back, which radiates to the buttock, anogenital region, and posterior surface of the thigh. In some cases, paresis, peripheral paralysis, and sensory disorders occur. Severe cases are characterized by paralysis of the buttocks and both legs. A characteristic feature of the complication can be considered the asymmetry of sensory and motor disorders.

Lumbar osteochondrosis can cause the development of myelogenous "intermittent claudication" syndrome, in which there is weakness in the legs while walking, frequent urge to urinate, and numbness in the lower torso. The cause of this discomfort is poor blood supply to the lower parts of the spinal cord. After rest, these sensations disappear.

With ischemia of the roots of the cauda equina, caudogenic "intermittent claudication" occurs - goosebumps and tingling sensations when walking. Over time, this symptom can rise higher, reaching the perineum, genitals and groin. Weakness in the legs goes away after a short rest.

Compression of the Adamkiewicz artery can occur due to unsuccessful sudden movement, heavy lifting, or shaking. This complication of osteochondrosis of the lumbar spine manifests itself as disorders of the pelvic organs, loss of sensitivity, the appearance of bedsores and atrophy of the leg muscles.

Osteochondrosis of the lumbar spine is manifested by aching pain in the lower back. Due to prolonged stay in an uncomfortable position, pain may intensify. After sleeping or resting in a supine position, the pain subsides or goes away completely.

The occurrence of stressful situations for the body can cause the development of an acute condition. Most often this happens during hypothermia, heavy loads, and sudden movements. An exacerbation is characterized by severe pain, which from the lumbar region can go down to the legs. The body can independently try to reduce the load on the affected part of the spine by strong tension in the lower back muscles. A patient with osteochondrosis of the lumbar spine tries to find a comfortable position in which the pain subsides.

Diagnosis of lumbar osteochondrosis

Diagnosis of osteochondrosis is carried out in several stages. The doctor needs to talk with the patient, ask about complaints, find out about the nature of the pain, where it is localized, at what time the painful sensations make themselves felt, their duration, intensity, etc. In addition, the doctor will find out under what conditions the pain appears, when it intensifies or subsides.

After this, the vertebrologist examines the anamnesis, i. e. history of the disease. The doctor will definitely clarify how long the painful condition lasts, what was the cause of the pain, and how you feel during the period when the discomfort disappears. An important point is preliminary treatment, as well as the effectiveness of certain treatment methods. A qualified doctor will definitely ask the patient about living and working conditions, range of motion, well-being under certain loads, and past illnesses. It is very important to find out whether the patient had injuries to the spine, whether he played sports, and whether any immediate relatives had spinal diseases.

The next step in diagnosis will be examination of the patient. The doctor will pay attention to the position of the head, legs and arms in relation to the body, gait, manner of holding, symmetry of body areas, condition of the skin in the damaged area, and the patient’s movements. After this, the range of motion of the spine and the level of damage are established. To do this, the doctor will ask the patient to bend forward, sideways, backward, ask him to move different parts of his back, and tilt his head. A healthy person should not experience any crunching or pain in their joints during such a simple test.

If the patient does not suffer from osteochondrosis, then he can reach his chest and shoulder with his chin. Head movements in each direction are about 60 degrees. An angle of 45 degrees is formed by bending sideways between the head and the upper cervical spine. The distance from the sacrum to the spinous process of the seventh cervical vertebra increases by 5-7 centimeters when bending forward. This distance is reduced by 5-6 cm when bending backwards. An experienced vertebrologist will pay attention to how the knee and hip joints participate in bending, and how the configuration of the spine changes.

Treatment of osteochondrosis of the lumbar spine

Lumbar osteochondrosis requires complex, intensive and long-term treatment. This is especially true for chronic cases with multiple intervertebral hernias and protrusions.

Effectivetreatment of osteochondrosis of the lumbar spineis achieved by reflex methods that do not cause side effects, but bring maximum benefit. Remember, recovery from such a serious illness cannot come quickly. In each case of lumbar osteochondrosis, the doctor prescribes an individual treatment regimen.

It is worth noting that manual therapy can only be used in cases where the patient’s spine is not damaged by protrusions and intervertebral hernias. The integrated use of these techniques allows you to restore normal blood microcirculation, eliminate congestion, vascular edema, relieve muscle spasms, restore the balance of metabolic processes in the tissues of the vertebrae and intervertebral discs, and also improve tissue nutrition in the lumbar region. As a result, the natural regeneration process is stimulated. It is worth noting that in case of lumbar osteochondrosis, manual therapy should be aimed at improving the functions of the spine.

Treatment procedures for lumbar osteochondrosis are complemented by the use of herbal remedies that improve innervation in the body and also restore the balance of metabolic processes. The vertebrologist will recommend nutritional correction and a more active lifestyle to patients. It is important to adjust your body weight, because excess weight puts additional pressure on the lower back and also aggravates the development of osteochondrosis of the lumbar spine.

An experienced specialist who treats osteochondrosis allows the patient to achieve serious results, as well as avoid surgery, improve motor activity, eliminate lower back pain, and comprehensively improve the body to prevent further exacerbations. Acute pain goes away after 1-3 sessions of manual therapy, and the positive effect of treatment is achieved on average after 10-15 sessions. Remember that timely initiation of treatment is a guarantee of achieving positive results.

During the period of exacerbation of pain in the lower back, the patient is recommended to remain in bed for 2-3 days. To quickly relieve pain, nonsteroidal anti-inflammatory drugs, painkillers, venotonics, diuretics, nicotinic acid, and B vitamins are prescribed. Walking with crutches, dry or underwater traction of the spine can also be prescribed to unload the spine. If necessary, blockades with glucocorticoids or paravertebral blockades with an anesthetic are prescribed.

Physiotherapeutic treatment of osteochondrosis of the lumbar spine may also include electrophoresis, laser therapy, and ultraviolet radiation. Physical therapy is a mandatory component of a comprehensive treatment program. Some exercises can be used in the acute stage, but almost all exercises are recommended to be performed after the pain has reduced. Thanks to regular physical exercise, tissue nutrition is restored, blood and lymph supply to the intervertebral discs is improved, and flexibility and elasticity of joints and cartilage are gradually restored. Thus, the patient's condition improves, and the interval between periods of exacerbation lengthens.

Spa treatment also has a good effect on health. In climatic resorts, iodine-bromine, hydrogen sulfide and radon baths are prescribed.

Surgical treatment methods are used only if the patient’s pain cannot be relieved by conservative methods for a long time, with paresis of the muscles of the lower extremities and disruption of the processes of natural urination and defecation. During the operation, the herniated disc is removed and the spinal segment is strengthened.

Prevention of lumbar osteochondrosis

Prevention of lumbar osteochondrosis consists of following simple rules recommended by a vertebrologist. Remember that the development of the disease can only be prevented by carefully following these rules, no matter what:

• Keep your lower back dry and warm, do not overcool your spine, and avoid drafts.
• Do not lift heavy objects or carry them over long distances.
• Try not to make sudden movements.
• Maintain correct posture when working and resting.
• Change your position as often as possible, trying not to stay in one position for a long time.
• Do physical therapy.
• Try not to stay in a bent position for a long time.
• When cleaning, use long mops, a broom, and a vacuum cleaner with a long tube so you don't have to bend over.
• Lift weights correctly: bend over with a straight back, or bend your knees, pick up the bags with a straight back and stand up straight. Keep your hands with the load as close to your body as possible.
• If you need to bend low to pick something up from the floor, such as under a table or bed, get down on one knee and keep your back straight.
• Distribute weights equally between two hands.
• Strengthen your gluteal muscles, stretch your spine, take a walk every day.
• Balance your diet, enrich your diet with dairy and plant products.
• Stick to the drinking regime - 1. 5-2 liters of water and herbal teas per day.
• Get rid of bad habits - alcohol, smoking, drugs.