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 of age, is characterized by gradual progression and, therefore, requires appropriate conservative or surgical treatment.

Development mechanism

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

The disease includes several pathogenetic links:

• Cartilaginous tissue dystrophy due to malnutrition is the main trigger of the pathology.
• Degeneration (damage and destruction) of spinal cartilage (intervertebral discs, articular surfaces of vertebral processes).
• An inflammatory reaction with tissue swelling, blood stagnation and pain.
• Change in the proportion 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 spinal cord roots, leading to interruption of 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 for several reasons:

• Hereditary predisposition that determines at a genetic level the nutritional characteristics of cartilaginous tissue.
• Diseases of the endocrine, digestive and cardiovascular systems.
• Autoimmune inflammatory 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 (cause a violation of the relationship of the components of the vertebrae with subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or spinal defects.

The realization 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.
• Long-term systematic stay of the human body in a standing position.
• Incorrect posture.
• Hypothermia, including local in the posterior region.
• 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 taken.

Symptoms of lumbar osteochondrosis

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

• Pain in the lower back, 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, on the root side of the compressed spinal cord.
• Increased tone (tension) of the back muscles in the lower back.
• Decreased muscle strength in one or both legs.
• Periodic “stinging” pain in the back, caused by local hypothermia and physical exertion.
• Loss of skin sensitivity on one or both legs, accompanied by numbness and tingling sensations.
• “Cold feet” - the skin becomes cold to the touch due to spasm of arterial vessels, caused by compression of the autonomic nerve fibers of the spinal roots.
• Impaired sweating - the skin on 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 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 in the form of an attack is possible, provoked by an inflammatory reaction and swelling of soft tissues in the region 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.
• 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 decreased skin sensitivity and decreased muscle strength.
• Radiculoischemia - compression affects 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 cartilage structures can lead to disability.

Diagnosis

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

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 test results, the doctor makes a conclusion and selects the appropriate treatment.

Lumbar spine treatment

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

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

The choice of the direction of treatment is made by the doctor.Based on the results of the clinical and additional examination, he determines the most appropriate 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, include:

• A balanced diet with limitation of fatty fried foods and exclusion of alcohol from the diet.
• Limit intense physical activity, including prolonged stay of the human body in the same position.
• Rationalization of the work and rest regime - a short rest should be provided for every hour of work (usually 10 minutes is enough).If you work standing or are sedentary, you can do some exercises during your rest.
• Give up bad habits, as nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilaginous tissue.
• Eliminate the impact of stress factors and negative emotions that worsen the course of any pathological processes in the body.

Following general recommendations allows you to prevent the progression of the pathological process, as well as increase the effectiveness of other areas of therapy.

Drug treatment

Prescribing medications is carried out during the conservative treatment of osteochondrosis.

Medicines from several pharmacological groups are used:

• Nonsteroidal anti-inflammatory drugs - reduce the severity of the inflammatory reaction in tissues 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 in the area of the spinal structures affected by the pathological process.Due to this, the manifestations of the pathological process are reduced and the infringement of the spinal roots is reduced.
• Chondroprotectors are agents that protect cartilaginous 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 state of microcirculatory structures, has an antioxidant effect, which is carried out by binding and neutralizing free radicals (“fragments” of organic molecules containing an unpaired electron and damaging cell membrane structures).

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

Surgical intervention

Surgery for osteochondrosis of the lumbar spine is indicated in case of pronounced changes, as well as in the absence of the necessary result after conservative therapy.It aims to eliminate defects in altered cartilaginous 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 that help speed up the healing process of the postoperative wound, as well as prevent the development of complications.Through the use of modern minimally invasive techniques, it was possible to significantly reduce the patient's stay in hospital.

Prevention

Prevention of the development of osteochondrosis of the lumbar spine includes following simple recommendations.It is important to limit the load on the spine, abandon bad habits, rationalize work and rest schedules and ensure adequate sleep.The diet aims to limit fried and fatty foods and ensure a sufficient supply of vitamins, minerals and plant fiber.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 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 an increase in 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.To prevent the progression of negative manifestations, you should immediately seek qualified medical help.