What is osteochondrosis of the lumbar spine?

Osteochondrosis of the lumbar region is a pathology of the musculoskeletal system, accompanied by degenerative-dystrophic changes in bone tissue and impaired function of the five lower vertebrae (from 20 to 24). The disease causes discomfort to the patient and is characterized by specific symptoms - pain, stiffness of movements. Osteochondrosis of the lower back occurs in waves, with periods of exacerbations and remissions. According to statistics, this form is one of the most common. Pathology left unattended often leads to irreversible changes and a significant deterioration in the quality of life. However, with a competent integrated approach, osteochondrosis can be successfully treated.

The main causes of pathology

There are no exact data on why degenerative-dystrophic changes in the spinal column occur. It is assumed that the initial mechanism of pathology development is premature age-related changes in the joints. They can be genetically determined - passed on by inheritance, but most often they are initially manifested under the influence of unfavorable factors.

Chief among them is the improper distribution of the load on the spine. Osteochondrosis of the lumbosacral spine can develop with:

• wearing high-heeled shoes;
• carrying a bag or backpack on one shoulder without alternating;
• sleeping or resting for a long time in an uncomfortable position;
• sedentary work;
• weight lifting.

People at risk for the development of osteochondrosis are older people who are characterized by natural destructive changes in cartilage and bone tissue, professional athletes who train daily and intensively, pregnant women whose center of gravity shifts as the fetus grows and the load on the lower back increases significantly, office workers, forced tothey spend a lot of time in a sitting position.

In addition to external risk factors, doctors also call a group of internal ones. This includes:

• previous injuries of the musculoskeletal system;
• curvature of the spine;
• flat feet;
• congenital dislocation or subluxation of the hip joint;
• autoimmune disorders;
• inflammation of joint tissue;
• pathologies of the circulatory system;
• endocrine diseases;
• obesity.

Osteochondrosis of the lower back can be provoked by intoxication and long-term dehydration, bad habits, lack of calcium and any mechanical impact on the lower back - bruises, blows, falls.

Osteochondrosis of the lumbar spine: symptoms

The pathology affects not only the bone tissue, but also the entire spinal movement segment - vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Osteochondrosis of the lumbar spine develops, the symptoms of which become apparent with significant damage, gradually and slowly. In the early stages it is moderate discomfort during exercise, in the later stages acute unbearable pain. Clinical signs are expressed in the acute phase. In the remission period, they disappear, and in the early stages this happens even without treatment.

Osteochondrosis of the lumbar spine - symptoms:

• pain in the affected area of the spinal column;
• radiating pain up to the shoulder blades or down into the pelvis and hip joints;
• persistent feeling of tension in the lower back;
• difficulty bending and turning the body;
• slouch
• lameness;
• muscle weakness or, conversely, increased tone;
• burning sensation.

Not all the described symptoms are always present at once. Pain may be associated with limited mobility, but not muscle weakness or stiffness. Any of the above signs will be a reason to consult a doctor.

Stages of the disease

The intensity of symptoms accompanying osteochondrosis of the lumbosacral spine directly depends on the degree of development of the pathology. There are four in total.

1. The first stage. The first structural and functional changes begin. Intervertebral discs dry out and can rupture. Symptoms at this stage are minor. Many patients mistake them for fatigue after a working day, wearing uncomfortable shoes or exercising. The key signs of early osteochondrosis are mild discomfort in the lower back, which increases with bending and turning. Mild pain is possible, which will go away on its own after rest.
2. The second stage. The height of the intervertebral discs decreases, the bone structures converge. This causes a new round of symptoms - stiffness when moving and pain. The pain becomes long-lasting and intense, and can spread to the pelvis and legs.
3. The third phase. At this stage the vertebrae become deformed. Protrusions are formed - intervertebral discs protrude into the area of the spinal canal, but the fibrous rings remain intact. The main symptoms are intense pain, disturbing even at rest, reduced sensitivity, grinding and clicking when moving, tingling and numbness of the lower back.
4. The fourth stage. Pathological changes continue to progress. The functions of the vertebrae are lost. Form of hernia. Osteophytes are formed - bone growths. Blood vessels can be pinched and nerve fibers. Against the background of worsening blood circulation, the functioning of the pelvic organs is disturbed. In men, the risk of erectile dysfunction increases, in women, disorders in the menstrual cycle are observed. Advanced osteochondrosis is manifested by sharp lumbago in the lower back, lameness, reduced mobility to complete immobility and elevated temperature.

If you are concerned about lumbar osteochondrosis, its treatment will directly depend on the stage at which the disease was diagnosed. In the early stages, the doctor has many more recovery methods and techniques in his arsenal. Detection of degenerative-dystrophic changes in the initial stages enables conservative treatment of the pathology, without resorting to surgical intervention.

Forms of pathology

The division into forms is based on the characteristics of the pain syndrome that always accompanies osteochondrosis of the lumbar sacral part of the spine. There are three in total:

1. Lumbago. This is an acute shooting pain that prevents movement. The causes of pain can be pinched nerves or muscle spasms.
2. Lumbodynia. This is a lingering, aching pain. It is characteristic of the phase of formation of protrusions and hernias. Also, discomfort may be associated with ligament sprains.
3. Sciatica. This is a severe pain that spreads to the pelvic area. The patient complains of pain when walking, sitting or changing body position.

Two more forms of pathology are distinguished depending on accompanying symptoms. The patient may be diagnosed with:

1. Radiculopathy. Accompanied by compression of nerve endings due to deformation of the vertebrae. In this form of the disease, sensitivity decreases and the affected area becomes numb. Pain and burning are expressed. Possible decrease in muscle tone, impaired reflexes, tingling in the legs.
2. Discogenic lumbar osteochondrosis. This is a serious condition in which the patient is limited in movement. His lower back and limbs went numb. Other symptoms are general weakness, fever, involuntary urination, and if the disease is prolonged, weight loss.

Danger of spine disease

If left untreated, osteochondrosis is fraught not only with unbearable pain and stiffness of movement, but also with numerous pathologies that can develop against its background. The most common complications:

• intervertebral hernia;
• inflammation of the sciatic nerve;
• radiculitis;
• paresis.

In order to prevent accompanying pathologies, it is necessary to start the treatment of osteochondrosis immediately from the moment of detection. With a competent approach to therapy, it is possible to stop or significantly slow down the destruction of bone and cartilage tissue.

Methods for diagnosing pathology

Osteochondrosis of the lumbar sacral spine must be distinguished from other pathologies of the musculoskeletal system, which can occur with similar symptoms. The primary stage is a consultation with a neurologist, orthopedist or surgeon. The doctor clarifies the complaints, collects the anamnesis, performs a physical examination, paying attention to the characteristics of the patient's posture and posture, the nature of his work activity, bad habits and accompanying diseases.

Instrumental techniques are used for the most accurate diagnosis:

• MRI;
• radiography;
• myelography with contrast agent;
• multislice CT.

Each of the diagnostic procedures allows the doctor to assess the condition of the lumbar and sacral spine at the current moment. The images clearly show structural changes in the vertebrae, which indicates the stage of osteochondrosis. Based on the obtained data, the specialist makes a decision on the tactics of further management of the patient.

Laboratory diagnosis is not critical, however, studies may be recommended if indicated. In particular, if lumbar osteochondrosis is diagnosed, treatment can be prescribed based on the results of blood tests. They are necessary for clarifying the intensity of inflammatory processes in the muscle fibers along the spinal column.

Lumbar osteochondrosis: treatment

The fight against pathology is carried out under the supervision of a neurologist and begins after a comprehensive diagnosis, when the degree and extent of tissue damage is determined. Modern medicine offers a number of effective conservative methods. If their use does not lead to the expected result, doctors resort to surgery.

Lumbar osteochondrosis: treatment with physiotherapy methods

All physiotherapeutic techniques are good because they affect the sacral and lumbar spine in a comprehensive way. This approach allows you to cope with pain, reduce inflammation and restore normal blood circulation.

When osteochondrosis of the lumbar spine progresses, treatment should be comprehensive. Patients with complaints are prescribed:

• electrophoresis - exposing the problem area to constant electric pulses with the possibility of using drugs for external use;
• diadynamic therapy - a variant of electrotherapy using pulse currents;
• magnetotherapy – treatment with alternating or static magnetic fields;
• ultrasound therapy - influence of high-frequency sound waves;
• shock wave therapy - exposure to low-frequency acoustic impulses;

It is important to consider two nuances. First, the effect of physiotherapeutic treatment is visible only after the course of procedures, the duration of which is selected individually for each patient. The second is that physiotherapy as an independent method works for osteochondrosis of the initial stage. In case of large lesions, it is recommended as an auxiliary technique in addition to medical and surgical treatment.

Lumbar osteochondrosis: drug treatment

Pharmacotherapy of lesions of the lumbar and sacral spine is aimed at alleviating acute pain and suppressing inflammatory processes. The method is relevant in the acute phase, when symptoms interfere with a full life.

How to treat lumbar osteochondrosis with drugs is always decided individually. A neurologist can prescribe drugs from different pharmacological groups. basic:

• NSAIDs (systemic and local) to suppress inflammation in the vertebrae and adjacent tissues;
• muscle relaxants to relieve muscle spasms;
• angioprotectors to improve blood circulation;
• chondroprotectors to protect intervertebral disc cartilage tissue from destruction;
• B vitamins to improve nerve conduction;
• analgesics for sharp pains that limit mobility.

Exercise therapy as a method of treating pathology of the sacral and lumbar region

Intensive training for osteochondrosis is strictly prohibited, but you cannot completely give up physical activity. On the contrary, exercises of moderate strength and duration help restore blood circulation and reduce pain.

How to treat osteochondrosis of the lumbar spine with exercise therapy:

1. Practice with an instructor. The coach will show you which exercises are allowed in a certain situation and make sure that they are performed correctly. Even the smallest flaws in technology can significantly reduce the effectiveness of training or even cause harm.
2. Prepare carefully for the lesson. Before exercising, it is recommended to warm up the muscles - you can gently massage the lower back and sacrum.  
3. Dose the load strictly. The lower back is a vulnerable area. To avoid overexertion, you need to monitor the duration of classes. Their optimal duration is no longer than 20 minutes.
4. Gradually increase the intensity of exercise. Simple exercises and short programs are suitable for beginners without experience. For those who have been doing exercise therapy for a while, you can move on to more complex options.
5. Don't forget to be regular. One-time training will not bring visible improvements. Pain in the lumbar and sacral spine is reduced if the patient regularly engages in exercise therapy - ideally twice a week.
6. Consider contraindications. Physical therapy has proven to be a safe method of helping with osteochondrosis, but there are limitations. You should stop exercising if you feel unwell: fever, weakness, or fever.

Lumbar osteochondrosis, the treatment of which should take into account the period of the disease, will not bother you if all the rules are strictly followed.

1. In the acute period. Only smooth and slow movements are allowed. If the pain increases during exercise, you must stop and rest the joints.
2. In the subacute period. The pain syndrome subsides, mobility returns, so you can slightly increase the intensity of training and increase its duration. But, in order to avoid deterioration, you need to carefully monitor your condition.
3. In remission. We allow a whole range of exercises for pathologies of the lumbar spine, but it is important to remember that overexertion is fraught with new aggravation of the disease.

If lumbar osteochondrosis is diagnosed with mild or moderate severity, physical education treatment can also take place at home. After perfecting the exercise technique under the supervision of the instructor, it is not forbidden to repeat the exercises at home. For training, you will need a gymnastic mat, a roller and a ball.

Modern rooms for exercise therapy and rehabilitation are equipped not only with traditional equipment, but also with special medical simulators. They help you recover from illness gently and safely, and also make activities more fun and interactive. For example, the neuromuscular rehabilitation system turns rehabilitation into an exciting competition with oneself. The patient stands on a moving platform and performs the exercises shown on the screen. Another important advantage of the simulator is the ability to monitor even the slightest progress in the patient's condition. The system evaluates the result of each performed exercise, and the doctor can see the progress from training to training. Knowing their own success also motivates patients to work harder and not give up.

Manual therapy

Good results can be achieved if physical therapy and drugs for lumbar pathology are supplemented with manual therapy. The method allows:

• eliminate hypertonus of muscle fibers;
• relieve pain;
• restoration of blood supply in the lumbar and sacrum area;
• improve the flow of metabolic processes.

Manual therapy is an effective way to properly redistribute the load on the spinal column and protect yourself from further destructive changes. The good thing about this method is that it not only relieves pain, but also prevents neurological disorders that often develop against the background of lumbar osteochondrosis.  

Currently, chiropractors combine massage and physical therapy methods, such as tekartherapy. Electromagnetic waves penetrate deep into the bone tissue and allow you to relieve pain attacks and quickly restore mobility.  

Surgical methods

Osteochondrosis of the lumbar spine, whose treatment with drugs, physiotherapy and exercise therapy is not always effective, significantly complicates the patient's life. In some cases, only surgical intervention is applicable to eliminate pain and restore back mobility. Modern methods and technological equipment allow performing minimally invasive operations with a shortened rehabilitation period.

The following methods of intervention are relevant for osteochondrosis:

• endoscopic excision of intervertebral hernia - using microsurgical instruments and a built-in camera;
• transfacet removal of intervertebral hernia - using neurosurgical tube dilators;
• laminectomy – surgical removal of pathologically altered bone processes;
• microdiscectomy – elimination of hernia protrusion.

Direct indications for surgical intervention are recurrent hernias, spinal stenosis, when the spinal canal narrows, and degenerative spondylolisthesis, a pathology in which the vertebrae are displaced relative to each other. In all other cases, if osteochondrosis of the lumbar spine is confirmed, doctors try to carry out treatment with conservative methods.

Disease prevention

Symptoms of osteochondrosis cause discomfort, and the treatment of the pathology can take a long time. It is much more effective to protect the vulnerable lumbar region from overstrain in advance. For preventive purposes, it is recommended:

1. Properly organize your workplace during office work. The back of the chair should support the lower back, and the table should match the height.
2. Avoid uncomfortable shoes. The optimal heel height for women is up to 5 cm. It is also advisable to exclude flat soles, as they contribute to foot deformation and flat feet - one of the factors.
3. risk of osteochondrosis.
4. Practice. Lifting of heavy objects should be avoided. Swimming, walking and cardio training are useful if there are no contraindications.
5. Eat a balanced diet. The diet must contain foods that are sources of calcium, phosphorus and vitamin B, namely fish, dairy products, leafy vegetables and cereals. These substances are needed to strengthen all elements of the joints and support the nervous system.
6. Make sure you get enough sleep. It is better to sleep on an orthopedic mattress of medium hardness. It will ensure an anatomically correct position in which the body rests from everyday stress.
7. Control your body weight. Obesity is one of the provoking factors. If the weight is normal, the load on the spine will be adequately distributed, and the risk of circulatory disorders will be minimized.

The prognosis for patients with osteochondrosis directly depends on the degree of damage to the vertebrae. That is why timely diagnosis is extremely important. If you are worried about pain in the lower back, and the images reveal destructive processes in the initial stages, you need to start treatment. In the early stages, medication and physical therapy are effective. In later cases, it is rarely possible to go without surgery. Exercise therapy can be used as an additional measure of help in any form and at any stage.