Osteochondrosis is a widespread disease of the spine, which affects the intervertebral discs and cartilage. The cervical and lumbar regions are more susceptible to such processes. Osteochondrosis of the lumbar region can cause constant pain in the lower back and significantly complicate a person’s life. In treating the disease, preference is given to conservative methods; surgical interventions are resorted to only in extreme cases.
Causes of lumbar osteochondrosis
Osteochondrosis is not so much a disease as it is often a natural phenomenon that occurs as a result of age-related degenerative changes in the spine. Normally, the disc in the lumbar spine acts as a shock absorber between two vertebrae and allows the joints and spine to move easily. The outer part of the disc, the annulus fibrosus, surrounds the soft inner core of the disc, the nucleus pulposus. Every person's spinal discs undergo degenerative changes as they age, but not everyone develops symptoms.
It is believed that osteochondrosis begins with changes in the fibrous ring, intervertebral disc and subchondral bone. The fibrous ring loses water, which makes it less able to withstand daily loads on the spine, distributing them incorrectly. Overload of the posterior part of the vertebra leads to arthritis of the facet joints and hypertrophy (growth, with the formation of osteophytes - bone growths) of the vertebral bodies adjacent to the affected disc.
Reference! According to statistics, 30% of people aged 30 to 50 years have some degree of spinal disc degradation.
There are two main pathophysiological causes of pain in lumbar osteochondrosis. One of the possible causes of pain is inflammation of the nerves as a result of rupture of the outer part of the disc and leakage of the inner core out. Inflammatory proteins are released, which irritate nerve tissue.
According to the second reason, the vertebrae, due to age-related deformation, are no longer able to effectively absorb the load. This causes abnormal movement of the spine and causes a painful spasm of the back muscles trying to stabilize the spinal column.
The outcome of osteochondrosis can be the destruction of segments of the spine, leading to radiculitis. Risk factors that trigger and accelerate degenerative processes in the spine are:
- Hereditary predisposition to diseases of the musculoskeletal system;
- Smoking;
- Previous injuries;
- Hormonal and vascular disorders;
- Excess body weight;
- Muscles that are too weak and do not provide the necessary support to the spine;
- Professional activities associated with heavy physical labor (athletes, loaders).
Stages of development of lumbar osteochondrosis
Disorders in the intervertebral discs, leading to their degeneration and destruction, occur gradually. The entire pathological process goes through several stages, according to which the stages (or degrees) of lumbar osteochondrosis are distinguished:
- The first stage (degree) is characterized by mild symptoms. Painful sensations develop against the background of irritation of the nerve endings by the nucleus pulposus, penetrating into the cracks of the fibrous ring.
- The second stage is characterized by displacement of the upper vertebra relative to the lower one, due to cracking of the core and ring. These pathological processes, in addition to pain during movement, cause the occurrence of neurological symptoms, sensations of numbness and instability of the affected area.
- The third stage is characterized by an increase in pain and the appearance of herniated intervertebral discs, due to a violation of the integrity of the fibrous ring. Pain, sensory impairment, and muscle weakness interfere with daily tasks. Due to pinched nerve roots, the functioning of the urinary and intestinal systems may be disrupted.
- The fourth stage corresponds to complete destruction of the intervertebral discs, they become fibrotic, and osteochondral growths of the vertebral bodies cause immobility of the spine in this section.
Symptoms of lumbar osteochondrosis
To get started, get advice from specialists:
- Neurologist
- Orthopedist
- Therapist
The main symptom of lumbar and sacral osteochondrosis is pain. It typically worsens when sitting for long periods of time, or when rotating, bending the spine, or lifting a load. The pain may radiate to the leg, groin, and be accompanied by a feeling of numbness and weakness. Moderate, aching, dull pain can be followed by attacks of exacerbation.
Symptoms directly depend on the stage of development of the pathology:
- In the early period, when degenerative changes are just beginning to appear, symptoms are minimal.
- The intermediate stage, which is characterized by weakening of the fibrous ring, may already manifest itself as lower back pain.
- In the later stage, when fibrosis develops in the structures and osteophytes form, the pain becomes less pronounced, but the mobility of the spine decreases significantly.
The sensitivity of the lower back may be increased when touched. Characteristic shooting pains in the buttocks, thighs, and tingling sensation are a sign of pinched nerve roots that occur as a result of degenerative changes in the disc. Patients with lumbar osteochondrosis have difficulty bending forward, backward and to the sides. Osteochondrosis can be complicated by herniated discs and narrowing of the spinal canal, accompanied by the appearance of additional symptoms.
Diagnosis of lumbar osteochondrosis
Making a diagnosis begins with collecting anamnesis, interviewing and examining the patient. The specialist will be interested in your complaints, physical activity, the presence of old injuries, bad habits, and cases of illness in close relatives. During a physical examination, the doctor palpates (feels) the lower part of the spine, looking for tender areas, inflammation, or any abnormalities. He may also check sensation and perform motor tests.
The most popular method for diagnosing lumbar osteochondrosis is x-ray examination. The image will show the presence of osteophytes, narrowing of the joint space of the disc, or the so-called "vacuum" symptom, when gas bubbles are detected in the thickness of the disc. Other methods used are:
- MRI showing hydration (the degree of saturation with water), the shape of the discs, their height, which allows identifying pinched nerves.
- CT scan, which allows you to study the condition of tissues in detail and diagnose disorders at the earliest stages.
- Provocative discography used to determine the location of the affected disc.
Reference! MRI is a fairly accurate diagnostic method, but it cannot detect rupture of the outer rings of the disc.
Treatment methods for lumbar osteochondrosis
The preferred treatment for lumbar degenerative disc disease associated with chronic pain is conservative treatment with physical therapy, exercise, and medications. For patients with lumbar osteochondrosis it is recommended:
- A daily routine that includes sufficient rest and adequate physical activity;
- Regular physical exercise aimed at strengthening muscles;
- Lifestyle adjustments, including nutritional review and weight loss.
Physiotherapy
Various physiotherapeutic techniques have been successfully used to reduce low back pain. Physiotherapy promotes regenerative processes in the disc, stimulates metabolic and transport processes, prevents the formation of adhesions and further damage.
Physiotherapeutic methods used to treat spinal osteochondrosis include:
- Electrical stimulation. Electrical impulses help relieve back pain and improve blood circulation in the affected spine.
- Ultrasound therapy. Ultrasound waves can penetrate deep layers of tissue and help relieve inflammation and pain.
- Magnetotherapy. Magnetic fields can improve blood circulation and metabolic processes in tissues, promoting their regeneration.
- Laser therapy. Laser beams can help relieve pain, stimulate blood circulation and stimulate tissue regeneration.
- Ultraphonophoresis. This method combines ultrasound therapy with the use of medications that penetrate into the deep layers of tissue and help relieve inflammation and pain.
Important! Contrary to popular belief, osteochondrosis can and should be treated. Without treatment, it will become a source of chronic pain and can lead to numerous problems, including disruption of the functioning of internal organs.
Drug treatment
To relieve pain that interferes with daily activities, patients are prescribed analgesics and non-steroidal anti-inflammatory drugs. According to indications, the doctor may prescribe stronger drugs: muscle relaxants, steroids and narcotic painkillers. Therapeutic blockades are administered with local anesthetics and glucocorticoids to relieve intense pain.
Surgery
Much less frequently, surgical intervention is used for osteochondrosis of the lumbar region. It may include disc arthroplasty or fusion of the lumbar spine (creating conditions for the fusion of two vertebrae, while pain is reduced by eliminating movement in this part of the spine).
If the movement of the spine is significantly impaired, special intervertebral spacers can be installed. For patients who do not respond to all other treatments, a total lumbar disc replacement may be performed.
Treatment of lumbar osteochondrosis at home
The most effective thing you can do at home to maintain functionality and control pain is to exercise. They will increase the flow of blood, oxygen and nutrients to the spine, helping to keep the cartilage hydrated and the spine flexible for as long as possible. In addition, during exercise, endorphins are released, which are natural pain relievers.
Frequent changes of position also bring relief. Some poses help to cope with an attack of pain: kneeling, reclining, lying down. A short rest is necessary and beneficial, but prolonged bed rest only worsens the condition. It is important to stay active to prevent the disease from progressing. Patients with lumbar osteochondrosis benefit from walking, swimming, cycling, yoga, Pilates, stretching exercises and strengthening the muscle corset. The following measures also help:
- Applying heat to the lower back improves blood circulation and relieves muscle spasms and tension.
- Ice packs will help relieve pain and reduce inflammation.
- Massage also relaxes muscles, relieves spasms, and reduces pressure on the spine, thus relieving pain. By increasing blood circulation in this area, metabolic processes are improved and tissues are enriched with oxygen.
- Use of orthopedic mattresses and pillows. They will help maintain the correct position of the spine during sleep.
- Correct distribution of the load on the spine. When lifting heavy objects, you should use proper lifting technique to avoid stressing the lumbar spine.
- Proper nutrition. Eating a balanced diet rich in calcium and vitamins will help maintain healthy bones and joints.
However, if you have pain or other symptoms, before starting treatment for osteochondrosis at home, you should consult your doctor to receive more precise recommendations and assess the condition of the spine.
Which doctor should I contact for lumbar osteochondrosis?
If symptoms characteristic of lumbar osteochondrosis appear, it is recommended to consult a neurologist or orthopedic doctor. If you have lower back pain, you can also make an appointment with a therapist. He will prescribe the necessary tests to make a diagnosis and refer you to a specialist.
Treatment of lumbar osteochondrosis
Specialists from the nearest clinic in your city or other locality are ready to understand the reasons and help cope with the pain. Doctors usually have extensive clinical experience and master all modern methods of treating and diagnosing osteochondrosis in women and men. For the most part, convenient location, excellent equipment and versatility of institutions are a priority of modern medicine, which allow you to quickly undergo any examination and restore the health of the musculoskeletal system. You can make an appointment by calling a clinic convenient for you, as well as on the website by filling out the online form.
Prevention of lumbar osteochondrosis
Effective methods for preventing lumbar osteochondrosis are:
- Regular physical activity. Keep in good physical shape. Strengthen your back muscles. Stretching and strengthening exercises for your back will help keep your spine healthy.
- Reduce stress on the spine: Avoid unnecessary stress on the spine. When lifting heavy objects, use proper lifting technique.
- Posture correction: ensure correct posture. Sit and stand straight, don't slouch. Choose an orthopedic pillow and mattress for sleeping to maintain the correct position of the spine while resting. Buy quality shoes with good cushioning and support.
- Take care of back support by using orthopedic chairs if, due to the nature of your profession, you are forced to sit for long periods of time. Avoid staying in one position for a long time. Take regular breaks and stretch your spine.
- Watch your weight. Excess weight can place additional stress on the spine.
- Avoid uncontrolled movements and back injuries. Be careful when playing sports or physical activity.
- Stop smoking, which can negatively affect your spinal health.
By following simple recommendations, you can live an active and fulfilling life, minimizing the risks of back pain. If you already have symptoms, pain in the lumbar spine, be sure to consult a doctor for diagnosis and treatment.