Lumbar osteochondrosis: symptoms and treatment

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

The pathology occurs more often in people over 40 years old, 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 connections:

• Cartilage dystrophy due to malnutrition is the main trigger of the pathology.
• Degeneration (damage and destruction) of the spinal cartilage (intervertebral discs, articular surfaces of the vertebral processes).
• An inflammatory reaction with tissue swelling, congestion 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 the nerve fibers of the spinal cord roots, which leads to disruption of impulse transmission and the subsequent development of corresponding neurological symptoms.

Changes in cartilage components develop gradually over a long period of time.By taking preventive and therapeutic measures in a timely manner, the progression of the disease can be slowed down.

Reasons

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

• Hereditary predisposition, which determines the nutritional properties of cartilage tissue at the genetic level.
• Diseases of the endocrine, digestive and cardiovascular systems.
• Autoimmune inflammatory diseases of the spinal joints (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 a violation of the relationship of the vertebral components with subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or defects of the spine.

Recognizing the negative impact of the cause is more possible given 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.
• Wrong posture.
• Hypothermia, also locally in the back area.
• Systematic exposure to stress, lack of sleep, irrational work and rest periods.

Knowing the causes and risk factors allows 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 lumbar area, which initially occurs as the load on the spine increases.Then it becomes constant, has a pulling or aching character and gradually increases.
• Pain radiating into the leg on the side of the pinched spinal cord root.
• 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 in one or both legs, accompanied by numbness and tingling.
• “Cold feet” – the skin feels cold due to spasms 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 area of sensory impairment caused by a violation of autonomic innervation.

Osteochondrosis is a chronic disease.Clinical symptoms gradually increase over a long period of time.Phases 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 paroxysmal increase in pain is possible, which is caused by an inflammatory reaction and swelling of the 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.
• Lumboischalgia – Pain occurs in the lower back and radiates to the buttocks or legs.
• Radiculitis is a pathological process associated with 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 the arterial vessels and severe motor disorders occur.

Each clinical form of osteochondrosis does not develop in isolation;They are usually combined with each other.As the disease progresses, the person's condition worsens.Severe destruction of the 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 you to visualize gross changes.Due to its accessibility, it has become widely used.
• Computed tomography is an X-ray method for scanning tissue layer by layer, which has high resolution and allows minimal changes to be visualized.
• Magnetic Resonance Imaging – Tissue visualization occurs due to the resonance effect of the nuclei of organic substances in a magnetic field.It involves scanning in layers, avoiding 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 examination results, the doctor makes a conclusion and selects the appropriate treatment.

Treatment of the lumbar spine

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

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

The doctor is responsible for choosing the direction of treatment.Based on the results of the clinical and additional examination, he determines the optimal treatment.

General recommendations and nutrition

General recommendations should accompany the treatment of osteochondrosis of the lumbar spine, regardless of the severity of the pathological process.This includes:

• A balanced diet with the restriction of fatty fried foods and the exclusion of alcohol from the diet.
• Restriction of heavy physical activity, including prolonged stay of the human body in one position.
• Rationalization of the work and rest regime - after each hour of work, a short rest break should be taken (usually 10 minutes is enough).If you work standing or sitting, you can do a little exercise during your rest time.
• Give up bad habits, as nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilage tissue.
• Elimination of the effects of stress factors and negative emotions that worsen the course of pathological processes in the body.

Following general recommendations makes it possible to prevent the progression of the pathological process and increase the effectiveness of other areas of therapy.

Drug treatment

The prescription of drugs is carried out as part of the conservative treatment of osteochondrosis.

Drugs of various pharmacological groups are used:

• Non-steroidal anti-inflammatory drugs – reduce the severity of the inflammatory reaction in the tissues and pain.Prescribed to reduce the intensity of manifestations of exacerbation of osteochondrosis.
• Muscle relaxants – medications reduce the tone of the striated muscles in the spine, thereby reducing tissue tension and compression of the spinal roots.
• Adrenal hormones and glucocorticosteroids – reduce the inflammatory response.
• Diuretics – reducing the severity of edema in the soft tissues of the area of spinal structures affected by the pathological process.This reduces the manifestations of the pathological process and reduces injury to the spinal roots.
• Chondroprotectors are active ingredients 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 microcirculation structures, has an antioxidant effect, which is achieved by binding and neutralizing free radicals (“fragments” of organic molecules that contain an unpaired electron and damage the membrane structures of cells).

The dosage and duration of medication are determined by the attending physician based on research results and the effectiveness of previous therapy.

Surgical intervention

In case of pronounced changes, as well as the lack of the necessary result after conservative therapy, surgery for osteochondrosis of the lumbar spine is indicated.The aim is to eliminate defects in the altered cartilage tissue with subsequent plastic surgery.In modern medical institutions, surgical interventions are performed using minimally invasive endoscopic techniques.In addition to surgical treatment, medications are prescribed that accelerate the healing process of the postoperative wound and prevent the development of complications.By using modern minimally invasive techniques, the patient's length of stay in the hospital was significantly shortened.

Prevention

Prevention of the development of osteochondrosis of the lumbar spine involves following simple recommendations.It is important to limit the load on the spine, give up bad habits, streamline your work and rest schedule, and get enough sleep.The diet aims to limit fried, fatty foods and ensure an adequate supply of vitamins, minerals and plant fiber.This makes it possible to normalize the functional state of the digestive system, improve the nutrition of the cartilage structures of the musculoskeletal system and slow down the degeneration processes.

The prognosis for life with osteochondrosis of the lumbar spine is favorable.The disease is characterized by gradual progression.Without 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 cause significant discomfort and reduce the quality of life.To avoid the progression of negative manifestations, you should promptly seek qualified medical help.