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.

Pathology is more common in people over 40 years old, it is characterized by gradual development, and therefore requires adequate conservative or surgical treatment.

Mechanism of development

The main mechanism for the development of osteochondrosis is a violation of the nutrition of the cartilage tissue of the spinal structure.

The disease includes several pathogenetic links:

• Cartilage tissue dystrophy due to malnutrition is the main trigger of pathology.
• Degeneration (damage and destruction) of spinal cartilage (intervertebral discs, articular surfaces of vertebral processes).
• Inflammatory response with tissue swelling, blood pooling, and pain.
• A change in the ratio of the anatomical structure of the lumbar spine (flattening the intervertebral disc with a decrease in its height), which leads to a decrease in the diameter of the hole between the vertebrae through which the spinal cord root passes.
• Compression of the nerve fibers of the spinal cord root, which leads to disruption of impulse pathways and the subsequent development of corresponding neurological symptoms.

Changes in the cartilaginous component 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.

Reason

Osteochondrosis of the lumbar spine is a polyetiological disease that develops due to several reasons:

• Hereditary tendencies determine at the genetic level the nutritional characteristics of cartilage tissue.
• Diseases of the endocrine, digestive, and cardiovascular systems.
• Inflammatory autoimmune diseases that affect 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 injury to the spine, especially in the lumbar region (the cause of the violation of the relationship of the vertebral components with the subsequent provocation of the development of dystrophy and degeneration).
• Congenital anomalies or deformities of the spine.

Awareness of the negative effects of the cause is more likely against the background of the following risk factors:

• Increased body weight, which increases the load on the spine.
• Long-term systematic maintenance of the human body in a standing position.
• Improper 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 possibility of the 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 an interesting or painful character and gradually increases.
• Pain radiating down 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, accompanied by numbness and tingling.
• "Cold feet" - the skin becomes cold to the touch due to spasm of the arterial vessels, which is caused by the compression of the autonomic nerve fibers of the spinal roots.
• Sweating is affected - the skin of the feet becomes dry or, on the contrary, sweating increases.
• Peeling of the skin in the area of sensitivity disorders caused by a violation of autonomic preservation.

Osteochondrosis is a chronic disease.Clinical symptoms increase gradually over a long period of time.A period of improvement (remission) is followed by a worsening of the pathology, which is accompanied by an increase in clinical symptoms.After exposure to provoking factors (hypothermia, physical and emotional stress, pressure), an increase in pain like a sudden attack is possible, provoked by an inflammatory reaction and swelling of soft tissues in the region of the spinal root.

Depending on the symptoms that occur, several clinical forms of the disease are distinguished:

• Lumbodynia is a periodic paroxysmal pain in the lower back that develops after exposure to a provoking factor.
• 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 impaired skin sensitivity and decreased muscle strength.
• Radiculoischemia - compression affects arterial vessels, and severe motor disorders develop.

Each clinical form of osteochondrosis does not develop separately;they are usually combined with each other.As it progresses, the person's condition worsens.Severe destruction of the cartilage structure can cause deformity.

Diagnostics

The diagnosis of osteochondrosis of the lumbar spine is based on the visualization of changes in the vertebrae, intervertebral discs and soft tissues.

For this purpose, several instrumental research methods are established:

• Radiography is a technique that allows you to visualize gross changes.It has become widespread because of its accessibility.
• Computed tomography is an x-ray method of tissue layer-by-layer scanning, which has high resolution and allows you to visualize minimal changes.
• Magnetic resonance imaging - tissue visualization is carried out due to the resonance effect of the nucleus of organic matter 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, additional examinations are prescribed.It includes blood tests, urine tests, liver tests, kidney tests, and electrocardiograms.Based on the analysis of all examination results, the doctor makes a conclusion and chooses 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 treatment direction is made by the doctor.Based on the results of clinical and additional examinations, 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, including:

• A balanced diet by limiting fatty fried foods and excluding alcohol from the diet.
• Limit 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 break should be provided (usually 10 minutes is enough).If you work standing or do not move, you can do a little exercise during breaks.
• Stop bad habits, because nicotine and alcohol accelerate the process of dystrophy and degeneration of cartilage tissue.
• Eliminates the effects of stress factors and negative emotions that worsen the course of any pathological process in the body.

Following general recommendations makes it possible to prevent the development of pathological processes, as well as increase the effectiveness of other areas of therapy.

Drug treatment

Drug prescription 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 relaxant - the drug reduces 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.
• Diuretic - reduces the severity of edema in the soft tissues of the area of the spinal structure affected by the pathological process.Due to this, the manifestation of the pathological process is reduced and the violation of the spinal root is reduced.
• Chondroprotectors are agents that protect cartilage tissue from damage and also contribute to its partial recovery.
• Vitamin B - normalizes metabolic processes in nerve tissue, improves the functional condition of damaged spinal roots after strangulation.
• Vitamin C (ascorbic acid) – improves the condition of the microcirculation structure, has an antioxidant effect, which is realized by binding and neutralizing free radicals ("fragments" of organic molecules that contain unpaired electrons and damage the structure of cell membranes).

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

Surgical intervention

Surgery for osteochondrosis of the lumbar spine is indicated in cases of significant changes, as well as the absence of the necessary results after conservative therapy.It aims to eliminate defects in the cartilage tissue that is changed with subsequent plastic surgery.In modern medical institutions, surgical interventions are performed using minimally invasive endoscopic techniques.Along with surgical treatment, medications are prescribed that help speed up the healing process of postoperative wounds, as well as prevent the development of complications.Through the use of modern minimally invasive techniques, it is 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, abandon bad habits, rationalize your work and rest schedule, and ensure adequate sleep.This diet aims to limit fried, fatty foods, and ensure an adequate 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 the nutrition of the cartilage structure of the musculoskeletal system, delaying the degeneration process.

The prognosis for life with osteochondrosis of the lumbar spine is good.The disease is characterized by gradual development.In the absence of therapeutic measures, the clinical picture of osteochondrosis is accompanied by an increase in symptoms.At the same time, a person's condition worsens, and the manifestations become permanent.They bring significant discomfort and reduce the quality of life.To avoid the development of negative manifestations, you should immediately seek qualified medical help.