Lumbar osteochondrosis: symptoms and treatment

Osteochondrosis of the lumbar spine is a common disease that reduces a person's quality of life and is one of the causes of disability.

Pathology is more common in people over 40 years old, is characterized by gradual progression, and therefore requires adequate conservative or surgical treatment.

Development mechanism

The main mechanism for the development of osteochondrosis is the violation of nutrition of the cartilage tissue of the spinal structures.

The disease includes several pathogenetic links:

• Cartilage tissue dystrophy due to malnutrition is the main driver of the pathology.
• Degeneration (damage and destruction) of the cartilage of the spine (intervertebral discs, articular surfaces of the vertebrae).
• Inflammatory reaction with tissue swelling, blood stagnation and pain.
• A change in the ratio of the anatomical structures of the lumbar spine (flattening of the intervertebral discs with a decrease in their height), which leads to a decrease in the diameter of the holes between the vertebrae through which the roots of the spinal cord pass.
• Compression of nerve fibers at the root of the spinal cord, which leads to disturbances in the passage of impulses and the subsequent development of corresponding neurological symptoms.

Changes in cartilaginous components develop gradually over a long period of time.Timely initiation of preventive and therapeutic measures makes it possible to slow down the progression of the disease.

Reasons

Osteochondrosis of the lumbar spine is a polyetiological disease that develops from several causes:

• Hereditary predisposition that determines the nutritional characteristics of cartilage tissue at the genetic level.
• Diseases of the endocrine, digestive and cardiovascular systems.
• Inflammatory autoimmune diseases affecting the joints of the spine (rheumatoid arthritis, systemic lupus erythematosus, rheumatism).
• Metabolic disorders in the human body.
• Systematic heavy physical work with increased load on the spine, weight lifting.
• Previous injuries to the spine, especially in the lumbar region (the cause of the violation of the relationship of the components of the vertebrae with the subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or defects of the spine.

Realization of the negative impact of the cause is possible against the background of the following risk factors:

• Increased weight, which increases the load on the spine.
• Long-term systematic stay of the human body in a standing position.
• Improper posture.
• Hypothermia, including local in the back area.
• Systematic exposure to stress, lack of sleep, irrational work and rest regime.

Knowing the causes and risk factors will enable the implementation of effective preventive measures.

Symptoms of lumbar osteochondrosis

The possible development of osteochondrosis is indicated by the appearance of the following characteristic symptoms:

• Pain in the lumbar region, which initially appears when the load on the spine increases.Then it becomes constant, has a dragging or painful character and gradually intensifies.
• Irradiation of pain in the leg from the side of the pinched root of the spinal cord.
• Increased tone (tension) of the back muscles in the lumbar region.
• Decreased muscle strength in one or both legs.
• Periodic "shooting" pain in the back, caused by local hypothermia and physical exertion.
• Loss of skin sensitivity on one or both legs, accompanied by numbness and a tingling sensation.
• "Cold feet" - the skin becomes cold to the touch due to the spasm of the arterial vessels, which is caused by the compression of the autonomic nerve fibers of the spinal roots.
• Sweating disorder - the skin of the feet becomes dry or, on the contrary, sweating increases.
• Peeling of the skin in the area of sensitivity disorder caused by violation of autonomic innervation.

Osteochondrosis is a chronic disease.Clinical symptoms gradually increase over a long period of time.Periods of improvement (remission) are followed by worsening of the pathology, which is accompanied by increased clinical symptoms.After exposure to a provoking factor (hypothermia, physical and emotional stress, stress), a sharp increase in pain is possible, caused by an inflammatory reaction and swelling of soft tissues in the area of the spinal roots.

Depending on the predominant symptoms, several clinical forms of the disease are distinguished:

• Lumbodynia is a periodic paroxysmal pain in the lower back that develops after exposure to provoking factors.
• Lumboishalgia – pain occurs in the lower back and spreads to the buttocks or legs.
• Radiculitis is a pathological process accompanied by compression of one or more roots, while the clinical picture is dominated by neurological symptoms, including impaired skin sensitivity and reduced muscle strength.
• Radiculoischemia - compression affects arterial vessels, and severe motor disorders develop.

Each clinical form of osteochondrosis does not develop in isolation;they are usually combined with each other.As it progresses, the person's condition worsens.Severe destruction of cartilaginous structures can lead to disability.

Diagnostics

The diagnosis of osteochondrosis of the lumbar spine is based on the visualization of changes in the vertebrae, intervertebral discs and soft tissues.

For this purpose, several instrumental research methods are prescribed:

• Radiography is a technique that allows you to visualize gross changes.It has become widespread due to its affordability.
• Computed tomography is an X-ray method of layer-by-layer tissue scanning, which has a high resolution and allows you to visualize minimal changes.
• Magnetic resonance - tissue visualization is performed due to the resonance effect of the nuclei of organic substances in the magnetic field.It involves scanning layer by layer, while eliminating radiation exposure to the patient's body.

In order to determine the nature and severity of possible functional changes in the body, an additional examination is prescribed.It includes blood tests, urine tests, liver tests, kidney tests, and an electrocardiogram.Based on the analysis of all examination results, the doctor makes a conclusion and selects the appropriate treatment.

Treatment of the lumbar spine

Therapy of osteochondrosis of the lumbar spine is complex and includes several areas:

• General recommendations and diet.
• Drug therapy.
• Surgical intervention.

The choice of treatment is made by the doctor.Based on the results of the clinical and supplementary examination, he determines the most optimal treatment.

General recommendations and diet

General recommendations should follow the treatment of osteochondrosis of the lumbar spine, regardless of the severity of the pathological process, they include:

• A balanced diet, limiting fatty fried foods and excluding alcohol from the diet.
• Limitation of heavy physical activity, including prolonged stay of the human body in one position.
• Rationalization of work and rest regime - after each hour of work, a short rest should be provided (usually 10 minutes is enough).If you work standing or sitting, you can get some exercise during your breaks.
• Giving up bad habits, because nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilage tissue.
• Removing the influence of stress factors and negative emotions that worsen the course of any pathological processes in the body.

Adherence to general recommendations makes it possible to prevent the progression of the pathological process, as well as to increase the effectiveness of other areas of therapy.

Drug treatment

Medicines are prescribed during the conservative treatment of osteochondrosis.

Medicines from different pharmacological groups are used:

• Nonsteroidal anti-inflammatory drugs - reduce the severity of the inflammatory reaction in tissues and pain.It is prescribed to reduce the intensity of manifestations of exacerbation of osteochondrosis.
• Muscle relaxants - drugs reduce the tone of striated muscles in the spine, thereby reducing tissue tension and compression of the spinal roots.
• Adrenal hormones and glucocorticosteroids – reduce the inflammatory response.
• Diuretics - reduce the severity of edema in the soft tissues of the spinal structures affected by the pathological process.Because of this, the manifestations of the pathological process are reduced and the injury to the spinal roots is reduced.
• Chondroprotectors are agents that protect cartilage tissue from damage and contribute to its partial restoration.
• B vitamins - normalize metabolic processes in nervous tissue, improve the functional state of spinal roots damaged after strangulation.
• Vitamin C (ascorbic acid) – improves the state of microcirculatory structures, has an antioxidant effect that is achieved by binding and neutralizing free radicals ("fragments" of organic molecules that contain an unpaired electron and damage membrane structures of cells).

The dose and duration of the drug is determined by the doctor based on the results of the research, as well as the effectiveness of the previous therapy.

Surgical intervention

Surgery for osteochondrosis of the lumbar spine is indicated in case of pronounced changes, as well as the absence of the required result after conservative therapy.It is aimed at removing the defect in the changed cartilage tissue with subsequent plastic surgery.In modern medical institutions, surgical intervention is performed using minimally invasive endoscopic techniques.Along with surgical treatment, drugs are prescribed to help speed up the healing process of the postoperative wound, as well as to avoid the development of complications.By using modern minimally invasive techniques, it was possible to significantly shorten the patient's stay in the hospital.

Prevention

Prevention of the development of osteochondrosis of the lumbar spine includes the following simple recommendations.It is important to limit the load on the spine, give up bad habits, rationalize the schedule of work and rest, and ensure adequate sleep.The diet is aimed at limiting fried, fatty foods and ensuring a sufficient amount of vitamins, minerals and plant fibers.This will enable the normalization of the functional state of the digestive system, as well as improve the nutrition of the cartilaginous structures of the musculoskeletal system, slowing down the degeneration processes.

The prognosis for life with osteochondrosis of the lumbar spine is favorable.The disease is characterized by gradual progression.In the absence of therapeutic measures, the clinical picture of osteochondrosis is accompanied by increased symptoms.At the same time, the person's condition worsens, and the manifestations become permanent.They bring significant discomfort and reduce the quality of life.In order to avoid the progression of negative manifestations, you should immediately seek qualified medical help.