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, it is characterized by gradual progression, and therefore requires adequate conservative or surgical treatment.
Development mechanism
The main mechanism for the development of osteochondrosis is a violation of the nutrition of the cartilage tissue of the spinal structures.
The disease includes several pathogenetic links:
- Dystrophy of cartilage tissue 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.
- 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 spinal cord roots pass.
- Compression of the nerve fibers of the spinal cord roots, leading to disruption 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 due to several causes:
- Hereditary predisposition that 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.
- Systematic heavy physical work with increased loads on the spine, weightlifting.
- Previous injuries to the spine, especially in the lumbar region (the cause of a violation of the relationship of the components of the vertebrae with subsequent provocation of the development of dystrophy and degeneration).
- Congenital anomalies or defects of the spine.
The realization of the negative impact of the cause is more 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.
- Incorrect posture.
- Hypothermia, including local in the back area.
- Systematic exposure to stress, lack of sleep, irrational work and rest regime.
Knowledge of the causes and risk factors will make it possible to carry out 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 pulling or aching character and gradually intensifies.
- Irradiation of pain 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, provoked by local hypothermia and physical exertion.
- Loss of skin sensitivity on one or both legs, which is accompanied by numbness and a tingling feeling.
- “Cold feet” - the skin becomes cold to the touch due to spasm of arterial vessels, which is 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 sensitivity disturbance caused by a violation of the autonomic innervation.
Osteochondrosis is a chronic disease.Clinical symptoms increase gradually over a long period of time.Periods of improvement (remission) are followed by exacerbation of the pathology, which is accompanied by increased clinical symptoms.After exposure to a provoking factor (hypothermia, physical and emotional stress, stress), a sharp attack-like increase in pain is possible, provoked by an inflammatory reaction and swelling of soft tissues in the area of the spinal roots.
Depending on the prevailing symptoms, several clinical forms of the disease are 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 buttock 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 severe motor disturbances 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.
Diagnostics
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.It has become widespread due to its accessibility.
- Computed tomography is an x-ray method of layer-by-layer scanning of tissue, which has high resolution and allows you to visualize minimal changes.
- Magnetic resonance imaging - tissue visualization is carried out due to the effect of resonance of the nuclei of organic substances in a magnetic field.It involves layer-by-layer scanning, 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 the 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 diet.
- Drug therapy.
- Surgical intervention.
The choice of treatment direction is made by the doctor.Based on the results of the clinical and additional 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 with limiting fatty fried foods and excluding alcohol from the diet.
- Limiting heavy physical activity, including prolonged stay of the human body in one position.
- Rationalization of the work and rest regime - after every hour of work, a short rest should be provided (usually 10 minutes is enough).If you work standing or sedentary, you can do a little exercise during rest.
- Quitting bad habits, as nicotine and alcohol accelerate the processes of dystrophy and degeneration of cartilage tissue.
- Eliminating the impact of stress factors and negative emotions that worsen the course of any pathological processes in the body.
Following general recommendations makes it possible to prevent the progression of the pathological process, as well as increase the effectiveness of other areas of therapy.
Drug treatment
Prescription of medications is carried out during 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 tissues and pain.Prescribed to reduce the intensity of manifestations of exacerbation of osteochondrosis.
- Muscle relaxants - drugs reduce the tone of the striated muscles in 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 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 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 realized 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 drug use are determined by the attending physician based on 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 the absence of the necessary result after conservative therapy.It is aimed at eliminating defects in the altered cartilage tissue with subsequent plastic surgery.In modern medical institutions, surgical intervention is performed 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 avoid the development of complications.Through the use of modern minimally invasive techniques, it was possible to significantly reduce the patient’s time in the 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, give up bad habits, rationalize your work and rest schedule, and ensure adequate sleep.The diet is aimed at limiting fried, fatty foods, and ensuring a sufficient supply of vitamins, minerals and plant fiber.This will make it possible to normalize the functional state of the digestive system, as well as improve 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 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 promptly seek qualified medical help.