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.

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

Development mechanism

The main mechanism of development of osteochondrosis is a violation of the nutrition of the cartilaginous tissue of the spinal structures.

The disease includes several pathogenetic links:

• Cartilage tissue dystrophy due to malnutrition is the main trigger of the pathology.
• Degeneration (damage and destruction) of spinal cartilage (intervertebral discs, articular surfaces of the vertebral processes).
• An 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), leading to a decrease in the diameter of the holes between the vertebrae through which the roots of the spinal cord pass.
• Compression of the nerve fibers of the roots of the spinal cord, leading to disruption of the passage of impulses and the subsequent development of corresponding neurological symptoms.

Changes in cartilage components develop gradually over a long period of time.The timely implementation of preventive and therapeutic measures helps slow the progression of the disease.

Reasons

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

• Hereditary predisposition which determines at the genetic level the nutritional characteristics of cartilage tissue.
• 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.
• Heavy, systematic physical work with increased loads on the spine, weightlifting.
• Previous injuries to the spine, especially in the lumbar region (cause of a violation of the relationship between the components of the vertebrae with subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or spinal defects.

Awareness of the negative impact of the cause is more possible in the context of the following risk factors:

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

Knowledge of the causes and risk factors will allow effective preventive measures to be implemented.

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 pulling or painful character and gradually intensifies.
• Radiation 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 “throbbing” 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 spasm of the arterial vessels, caused by compression of the autonomic nerve fibers of the spinal roots.
• Impaired sweating - the skin of the feet becomes dry or, on the contrary, sweating increases.
• Peeling of the skin in the zone of sensitivity disturbance caused by a 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 an exacerbation of the pathology, which is accompanied by an increase in clinical symptoms.After exposure to a provoking factor (hypothermia, physical and emotional stress, stress), a sharp increase in pain, similar to a seizure, is possible, caused by an inflammatory reaction and swelling of soft tissues at the spinal roots.

Depending on the dominant symptoms, several clinical forms of the disease can be distinguished:

• Lumbodynia is periodic paroxysmal pain in the lower back that develops after exposure to provoking factors.
• Lumboischalgia – pain occurs in the lower back and radiates 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 decreased muscle strength.
• Radiculoischemia - compression affects the arterial vessels and serious 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.

Diagnosis

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 sudden changes.It became widespread due to its accessibility.
• Computed tomography is an X-ray method of layer-by-layer scanning of tissues, which has high resolution and allows you to visualize minimal changes.
• Magnetic resonance imaging - visualization of tissues is carried out due to the resonance effect of the nuclei of organic substances in a magnetic field.This involves scanning layer by layer, while eliminating radiation exposure to the patient's body.

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 the examination results, the doctor draws a conclusion and selects the appropriate treatment.

Lumbar spine treatment

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

• General recommendations and diet.
• Drug therapy.
• Surgery.

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

General recommendations and diet

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

• A balanced diet by limiting fatty fried foods and excluding alcohol from the diet.
• Limit strenuous physical activity, including prolonged holding of the human body in one position.
• Streamlining the 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 sedentary, you can do some exercise during rest.
• Give up bad habits, because nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilage tissue.
• Eliminate the impact of stress factors and negative emotions that aggravate the course of any pathological processes in the body.

Following general recommendations helps prevent the progression of the pathological process and increase the effectiveness of other areas of therapy.

Drug treatment

Prescription of medications is carried out during conservative treatment of osteochondrosis.

Medicines of various pharmacological groups are used:

• Nonsteroidal anti-inflammatory drugs - reduce the severity of the inflammatory tissue reaction and pain.Prescribed to reduce the intensity of manifestations of exacerbation of osteochondrosis.
• Muscle relaxants - medications reduce the tone of the striated muscles of the spine, thereby reducing tissue tension and compression of the spinal roots.
• Adrenal hormones and glucocorticosteroids – reducing the inflammatory response.
• Diuretics – reducing the severity of edema in the soft tissues of the area of spinal structures affected by the pathological process.Due to this, the manifestations of the pathological process are reduced and the violation of the spinal roots is reduced.
• Chondroprotectors are agents that protect cartilage tissue from damage, and also 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 condition of microcirculatory structures, has an antioxidant effect, which is achieved by binding and neutralizing free radicals (“fragments” of organic molecules containing an unpaired electron and damaging the membrane structures of cells).

The dosage and duration of use of the drug are determined by the attending physician based on research results, as well as the effectiveness of previous treatment.

Surgery

Surgery for osteochondrosis of the lumbar spine is indicated in cases of pronounced changes, as well as the absence of the necessary result after conservative treatment.It is aimed at eliminating defects in altered cartilage tissue with subsequent plastic surgery.In modern medical institutions, surgical intervention is carried out using minimally invasive endoscopic techniques.Along with surgical treatment, medications are prescribed to accelerate the healing process of the postoperative wound and avoid the development of complications.Thanks to the use of modern minimally invasive techniques, it was possible to significantly reduce the patient's hospital stay.

Prevention

Prevention of the development of osteochondrosis of the lumbar spine consists of following simple recommendations.It is important to limit the load on the spine, abandon bad habits, streamline your work and rest schedule, and ensure sufficient sleep.The diet aims to limit fried and fatty foods and ensure sufficient intake of vitamins, minerals and plant fibers.This will normalize the functional state of the digestive system, as well as improve the nutrition of the cartilaginous structures of the musculoskeletal system, slowing down the processes of degeneration.

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 an increase in symptoms.At the same time, the person's condition worsens and the manifestations become permanent.They bring significant discomfort and reduce quality of life.In order to prevent the progression of negative manifestations, you should promptly consult a qualified doctor.