Symptoms and methods of treatment of osteochondrosis of the lumbar spine

The most common cause of back pain is the development of such a disease of the musculoskeletal system as osteochondrosis. If earlier this pathology was found mainly in older people and less often in middle age, now osteochondrosis has become much younger, it is often diagnosed in people whose age is 20-30 years.

According to medical statistics, most often the disease affects the lumbar and lumbosacral spine.

Characteristics of the disease

Osteochondrosis is a pathology of the musculoskeletal system that affects its most important component - the spine. It arises due to the fact that dystrophic changes in the intervertebral discs begin to develop.

The disease affects not only the tissue of the intervertebral discs, negative changes begin to occur in the surrounding tissues, affecting the ligaments and muscles.

The reason for the prevalence of the lumbar form of osteochondrosis is that this particular part of the spine is subjected to the greatest physical stress.

With this disease, characteristic changes occur in the nucleus pulposus, which is part of the intervertebral disc. This disc performs amortization functions.

If the water exchange in the intervertebral discs is disturbed, they become thinner, and their fragility increases.

People of older age groups are most susceptible to the pathological process, since metabolic processes in the tissues of the intervertebral discs begin to deteriorate when they reach a certain age.

Under the influence of negative changes, the boundaries of the nucleus pulposus gradually expand, it tends to enter the intervertebral space. This usually ends with the displacement of the nucleus to the spinal canal, as a result of which its compression and pinching of nerve fibers and blood vessels occur.

Pinched nerves are the cause of pain in osteochondrosis. There may also be a deterioration in the functioning of internal organs.

With the progression of pathology, the force of pressure on the vertebrae increases. The body seeks to compensate for the defect, and the growth of the bone tissue of the spine is significantly accelerated. As a result, pathological growths - osteophytes - form on the vertebrae. Ultimately, this further disrupts the functionality of the affected spine.

With advanced forms of osteochondrosis, the patient may experience paralysis of the lower extremities. Due to late access to medical care, a person can become disabled.

Causes of osteochondrosis of the lumbar and lumbosacral spine

Osteochondrosis of the lumbar and lumbosacral spine develops due to improper distribution of the load on the spine. If this is combined with other negative factors, the progression of osteochondrosis is accelerated, it can take on more severe forms.

Disease can be provoked by:

• regularly performing heavy physical work, lifting heavy objects (people of certain professions, as well as athletes involved in weightlifting, are at risk);
• insufficient physical activity, which negatively affects the condition of the muscles and leads to a deterioration in blood circulation, metabolic processes and a decrease in the amount of nutrients entering the tissues;
• the patient is overweight, which leads to the fact that the spine is constantly exposed to heavy loads;
• problems with posture and improper gait;
• the presence of congenital deformities or other defects of the spine or the entire skeleton;
• flat feet can also cause the development of osteochondrosis, since in patients with deformity of the foot, its arch cannot fully absorb the loads during movement, which leads to increased loads on the intervertebral discs;
• traumatic spinal injury;
• genetically determined disorders of bone tissue formation;
• age-related changes;
• infections affecting bone tissue (tuberculosis, osteomyelitis);
• inflammatory processes affecting bones and joints (including rheumatoid arthritis, ankylosing spondylitis);
• deficiency of vitamins and minerals;
• exposure to harmful and toxic substances.

The most common cause of pathology is heavy loads on the spine in patients with improper posture.

Disease Symptoms

The manifestation and severity of symptoms of osteochondrosis depend on the stage of the disease.

There are 4 stages of the disease:

1. The first stage is characterized by the appearance of pain in the lumbar region (lumbago), spasms of the surrounding muscle tissues, and swelling in the affected area. During this period, a change and displacement of the nucleus pulposus of the intervertebral discs begins, which causes irritation of the nerve endings.
2. At the second stage, the process of destruction of the fibrous rings of the intervertebral discs starts. The vertebrae become unstable, their mobility increases, as a result of which there is a steady tension of the neighboring muscles. Pain is noted along the sciatic nerve. At this stage of the disease, disruptions in the work of internal organs can sometimes begin.
3. During the third stage, rupture of the fibrous rings and the release of the contents of the nucleus pulposus are observed. As a result, herniated discs are formed. All this contributes to further deformation of the spine (the development of scoliosis, kyphosis or lordosis may be observed). Acute pains become permanent, this is due to radicular syndrome, in which the nerve roots are compressed by fragments that have fallen out of the fibrous rings.
4. The fourth stage is characterized by severe deformities of the spinal column, pathological growths appear on the vertebrae. There may be significant relief of pain, but this does not mean improvement in the patient's condition. On the contrary, a person's movements become severely limited. Usually, patients with stage 4 osteochondrosis require disability registration.

One of the main symptoms of the disease is pain in the lumbar region, which can also spread to the tailbone and lower extremities. It is divided into 3 types:

1. Lumbago- attacks of acute pain that begin when making sudden movements or lifting heavy objects.
2. Lumbodynia- severe regular pain associated with damage to the intervertebral cartilage and muscle fibers.
3. Lumboishalgia- characterized by a sensation of pain, feeling of coldness or heat in the lumbar region, as well as in the legs.

The psychological state of a person can also provoke pain.

In addition to pain, osteochondrosis is characterized by:

• feeling of weakness in the lower half of the body and in the legs;
• deterioration of the tendon reflexes of the lower extremities;
• tingling, which can be felt from the lower back to the foot;
• curvature of the spinal column;
• with lumbosacral osteochondrosis, there is often a malfunction in the functioning of the pelvic organs (urination disorder, fecal incontinence, erectile dysfunction);
• skin problems (dryness, flaking, bluish tinge) and changes in sweating may also occur in the lower back and buttocks.

If you find the listed symptoms, you should consult a doctor as soon as possible in order to start treatment promptly and prevent serious consequences.

Treatment of osteochondrosis of the lumbar and lumbosacral spine

Medical

For a patient diagnosed with osteochondrosis, the doctor may prescribe the following types of therapy (including several at once):

• medication treatment;
• physiotherapy procedures;
• medical massage and manual therapy;
• performing a surgical operation.

Let's take a closer look at each of these methods.

Medicines are prescribed to relieve pain, fight inflammation and improve the regeneration of diseased tissues. The patient may be assigned:

• analgesics (help relieve pain);
• muscle relaxants (used to relax muscle fibers and relieve spasms);
• chondroprotectors (promote the regeneration of cartilage and bone tissues and protect them from negative influences);
• anti-inflammatory drugs;
• in case of edema, diuretics (diuretics) are prescribed;
• medicines that improve blood circulation;
• vitamin and mineral complexes.

In common forms of osteochondrosis, when conventional analgesics are ineffective, blockades may be prescribed. What specific drugs should be used, as well as the scheme and duration of treatment, is determined by the doctor, taking into account the stage of the disease and the severity of symptoms.

It is advisable to prescribe physiotherapy along with drugs to increase the effectiveness of treatment. With osteochondrosis, the following procedures are indicated:

• laser therapy;
• magnetic resonance therapy;
• phonophoresis;
• shock wave therapy.

These treatments help relieve pain, reduce inflammation, and help repair damaged tissue. The use of a laser beam is very effective, this allows you to get a stable remission.

When prescribing phonophoresis, additional topical drugs are used (this method allows the drug to penetrate deep under the skin directly to the lesion). To maximize the enrichment of tissues with oxygen, the doctor may also prescribe ozone therapy.

It should be borne in mind that physiotherapy is contraindicated in certain pathologies. It should not be prescribed to patients with cancer, thyrotoxicosis, diabetes, tuberculosis, infectious diseases.

Massage and manual therapy can be prescribed simultaneously with medications and physiotherapy procedures, which enhances the therapeutic effect.

These methods affect the conduction of nerve impulses and help to normalize muscle tone.

Surgical intervention is indicated only in the later stages of the disease, when other methods of treatment are useless. Surgery is required if:

• the patient suffers from severe pain that cannot be controlled by drugs;
• disc herniation;
• the patient is diagnosed with spinal cord compression (this leads to impaired sensitivity and motor functions - from a feeling of weakness to paralysis);
• the development of the cauda equina syndrome is noted.

Nowadays, modern high-tech and low-traumatic operations are being carried out more and more often, allowing to significantly shorten the rehabilitation period. In the absence of complications, the patient will be able to move normally within a few months after surgery.

Folk remedies

Traditional medicine treatments help relieve pain, reduce inflammation, and improve mobility. Here are several ways to treat osteochondrosis with folk remedies.

1. You need to take raw potatoes, grate them and mix with natural honey. The resulting mixture should be placed on your back and secured with a bandage for at least 2 hours. Applying warm boiled potatoes to the affected area also helps.
2. Grate the garlic and mix in equal parts with ginger. Then add some olive oil. The resulting drug must be rubbed into the back at night to improve blood circulation and reduce muscle tension.
3. Mix a spoonful of menthol oil with a spoonful of fir oil. The mixture should be rubbed into the back.
4. Take chopped pine or spruce needles in the amount of ½ tablespoon per 200 ml (1 glass) boiling water and let it brew for 30 minutes. Drink ½ glass 2 times a day.
5. Mix a tablespoon of lingonberry and mint herbs, boil with boiling water (1 glass), let it brew and strain. Drink the broth gradually throughout the day.

It is important to understand that treatment with folk remedies cannot replace a visit to a doctor. Folk methods temporarily relieve symptoms, but they do not completely eliminate the disease.

In addition, they may not be suitable for every patient, therefore it is strongly recommended to consult a specialist before using them.

Physiotherapy exercises

Physiotherapy exercises are aimed at strengthening the muscles of the lower back, buttocks and thighs, which helps to relieve pain, reduce the degree of pinching of nerves and blood vessels, and restore flexibility.

For the exercises to be as effective as possible and not to cause harm, certain guidelines must be followed:

• Exercises should be performed in natural fabric clothing that does not restrict movement;
• the lumbar region during physical education should not be hypothermic;
• if you need to take a lying position to perform the exercise, it is better to put a round roller under the lower leg;
• you should start exercising no earlier than an hour after eating;
• to obtain a sustainable positive effect, it is necessary to engage in physiotherapy exercises regularly;
• exercises should be performed smoothly, slowly, concentrating on muscle work;
• you need to monitor your breathing, it should be even and deep;
• it is helpful to keep a diary that includes changes since the day you start doing the exercises.

Which exercises should be performed depends on the severity of the symptoms of osteochondrosis.

In acute lumbar osteochondrosis, the spine should not be loaded, you should adhere to bed rest (preferably using an orthopedic mattress), and you can do physical education while lying on your back, repeating each movement 8-10 times. Here are some suggestions:

1. Lying on your back, put a roller under your shins and bend your knees. The patient should bend his arms into a fist and unbend, and also need to bend the legs at the ankle. These movements are done alternately with each arm and leg.
2. You need to alternately bend and unbend your legs, moving only your knees. At the same time, the back should not move.
3. Rotate each foot in turn.
4. Extend the arms and legs, then begin flexing and extending the elbows of both arms at the same time. During flexion, you need to inhale, and during extension, exhale. Keep your hands palms up.

Recommended exercises for subacute lumbar osteochondrosis:

1. With your knees bent in a supine position, rest your feet on the mattress. While inhaling, gently raise the sacrum, while the lower part of the thoracic spine should rest on the mattress. After 1-2 seconds, gently lower the lower half of the back.
2. Lying on a mattress, while inhaling, you need to raise your head and tighten your abdominal muscles. On exhalation, return to the starting position.
3. In the supine position, pull the heel to the buttocks in a sliding motion, without lifting it from the mattress. After a few seconds, straighten your leg. The movements should be repeated for each leg separately and for both legs at the same time.
4. From a position on all fours, sit with your buttocks on your heels, making sliding movements with your hands on the mattress. Then take the starting position.
5. Get on all fours, relax your neck. Tighten your chin to your chest, bend your back in the lower back like a cat, fix this position for a few seconds. It is necessary to ensure that the head does not rise, and the back maintains its accepted position.

Patients who have achieved remission can do any of the above exercises.

Physiotherapy exercises, if possible, should be done 3-4 times a day for any form of lumbar osteochondrosis, but before starting to perform them, you should definitely consult a doctor.

Preventive measures

Osteochondrosis, like most other ailments, is much easier to prevent than to try to get rid of its consequences later. To minimize the likelihood of developing the disease, it is recommended:

• to ensure that the diet is healthy and balanced;
• lead an active life, move as much as possible;
• do not subject the spine to excessively heavy loads;
• do exercises to strengthen your back muscles.

It is also necessary to promptly treat diseases and injuries that can lead to the development of osteochondrosis. If even minor symptoms appear that may signal problems with the spine, you should not delay the visit to the doctor.

Conclusion

Osteochondrosis of the lumbar spine is a disease that must be taken as seriously as possible in order to avoid serious consequences. If you adhere to a healthy lifestyle and follow the recommended preventive measures, the likelihood of developing pathology will be minimal.

If symptoms of the disease do appear, you should see a doctor as soon as possible. Timely medical care is the key to stable remission, which allows you to stop the pathological process, preserve the patient's ability to work and, to a certain extent, restore the previous state of the musculoskeletal system.