What is lumbar osteochondrosis?

Osteochondrosis of the lumbar region is a pathology of the musculoskeletal system accompanied by degenerative-dystrophic changes in the bone tissue and disruption of the five lower vertebrae (from 20 to 24). The disease causes discomfort in the patient and is characterized by specific symptoms - pain, stiffness of movement. Osteochondrosis of the lower back occurs in waves, with periods of exacerbation and remission. According to statistics, this form is one of the most common. Uncontrolled pathology 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 is no clear information about why degenerative-dystrophic changes in the spine are triggered. It is believed that the starting mechanism of the development of pathology is premature age-related changes in the joints. They can be determined genetically - they are transmitted by inheritance, but in most cases they manifest themselves initially under the influence of unfavorable factors.

The most important of them is the improper distribution of the load on the spine. Osteochondrosis of the lumbar-sacral spine can develop with:

• wearing high heels;
• carrying a bag or backpack on one shoulder in turn;
• sleeping or resting for a long time in an uncomfortable position;
• sedentary work;
• lifting weights.

The risk group for the development of osteochondrosis includes the elderly, characterized by natural destructive changes in cartilage and bone tissue, professional athletes who do daily and intensive training, pregnant women whose center of gravity changes as the fetus grows, and the load on the lower muscles. the waist increases significantly, office workers are forced to spend a lot of time in a sitting position.

In addition to external risk factors, doctors also call an internal group. These include:

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

Osteochondrosis of the lower back can also be caused by intoxication and long-term dehydration, bad habits, calcium deficiency and any mechanical effects on the lower back - bruises, blows, falls.

Osteochondrosis of the lumbar spine: symptoms

The pathology affects not only the bone tissue itself, but also the entire movement segment of the spine - vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Osteochondrosis of the lumbar spine develops, its symptoms are gradually and slowly manifested with significant damage. In the early stages, it is moderate discomfort during exercise, and in the later stages, it is severe unbearable pain. Clinical signs appear in the acute stage. During remission, 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 spine;
• radiating pain to the area of the shoulder blades or to the pelvic and hip joints;
• constant feeling of tension in the lumbar region;
• difficulty bending and turning the body;
• to bend;
• lameness;
• muscle weakness or, conversely, increased tone;
• tingling sensation.

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

Stages of the disease

The intensity of symptoms accompanied by osteochondrosis of the lumbar-sacral spine directly depends on the degree of development of the pathology. There are only four of them.

1. The first stage. The first structural and functional changes begin. Intervertebral discs dry out and can crack. Symptoms at this stage are few. Many patients mistake them for fatigue after a day at work, wearing uncomfortable shoes, or exercising. The main symptoms of early osteochondrosis are mild discomfort in the lower back, which increases with bending and turning. Slight 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 get closer to each other. This leads to a new stage of symptoms - stiffness and pain when moving. The pain is long and strong and can spread to the pelvis and legs.
3. The third stage. At this stage, the vertebrae are deformed. Protrusions are formed - the intervertebral discs protrude into the area of the spinal canal, but the fibrous rings remain intact. The main symptoms are severe pain, disturbing even at rest, decreased sensitivity, crunching and clicking when moving, tingling and numbness in the lower back.
4. The fourth stage. Pathological changes continue. The functions of the spine are lost. Hernias are formed. Osteophytes - bone growths - are formed. Blood vessels can be compressed and nerve fibers can be compressed. Against the background of the deterioration of blood circulation, the activity of the pelvic organs is disturbed. In men, the risk of erectile dysfunction increases, and in women, there is a violation of the menstrual cycle. Advanced osteochondrosis is manifested by acute lumbago in the lumbar region, lameness, impaired mobility up to complete immobilization, and an increase in temperature.

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

Forms of pathology

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

1. Lumbago. This is a sharp shooting pain that makes it impossible to move. Pain can be caused by pinched nerves or muscle spasms.
2. Lumbodynia. It is a painful pain that lasts for a long time. It is characteristic of the stage of formation of protrusions and tears. Also, discomfort can 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.

Depending on the accompanying symptoms, two more forms of pathology are distinguished. The patient may be diagnosed with:

1. Radiculopathy. It is accompanied by compression of the nerve endings due to the deformation of the spine. With this form of the disease, sensitivity decreases and the affected area becomes numb. A feeling of pain and tingling is expressed. A possible decrease in muscle tone, impaired reflexes, tingling in the legs.
2. Discogenic lumbar osteochondrosis. This is a serious condition that limits the patient's movement. His back and legs are numb. Other symptoms are general weakness, fever, involuntary urination, and weight loss if the disease lasts for a long time.

The danger of spinal diseases

Untreated osteochondrosis is fraught not only with unbearable pain and stiffness of movement, but also with a number of pathologies that can develop against its background. The most common complications are:

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

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

Pathology diagnosis methods

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

Instrumental methods are used for the most accurate diagnosis:

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

Each of the diagnostic procedures allows the doctor to assess the current state of the lumbar and sacral spine. The pictures clearly show the structural changes in the vertebrae showing the stage of osteochondrosis. Based on the received information, the specialist makes a decision about the tactics for the further management of the patient.

Laboratory diagnostics are not essential, but 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 to clarify the intensity of inflammatory processes in the muscle fibers adjacent to 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 extent and degree 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 methods are good because they comprehensively affect the sacral and lumbar spine. 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. It is prescribed to patients with complaints:

• electrophoresis - exposure of 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 - the effect of high-frequency sound waves;
• shock wave therapy - exposure to low-frequency acoustic pulses;

It is important to consider two nuances. First, the effect of physiotherapeutic treatment is noticeable only after a course of procedures, the duration of which is selected individually for each patient. Secondly, as an independent method, physiotherapy works for primary osteochondrosis. It is recommended as an adjunctive technique in addition to medical and surgical treatment for large-scale lesions.

Lumbar osteochondrosis: drug treatment

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

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

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

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

Intensive training for osteochondrosis is strictly prohibited, but you cannot completely refuse physical activity. On the contrary, moderate strength and long-term exercises help to restore blood circulation and reduce pain.

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

1. Practice with an instructor. The trainer will show you what exercises are allowed in a certain situation and will make sure that they are performed correctly. Even the smallest flaws in technology can significantly reduce the effectiveness of training or even harm it.
2. Prepare carefully for the lesson. It is recommended to warm up the muscles before exercise - you can gently massage the lower back and sacrum.  
3. Dose the load seriously. The lower back is a sensitive area. In order to avoid excessive stress, it is necessary to monitor the duration of the lessons. Their optimal duration is no more than 20 minutes.
4. Gradually increase the intensity of the exercise. Simple exercises and short programs are suitable for inexperienced beginners. For those who have been practicing exercise therapy for some time, you can move on to more complex options.
5. Remember to be regular. A one-time workout will not produce visible improvements. If the patient engages in exercise therapy regularly - optimally twice a week - the pain in the lower back and sacral lumbar region decreases.
6. Consider the contraindications. Physical therapy has proven to be a safe way to help with osteochondrosis, but there are limitations. If you feel bad, you should stop exercising: fever, weakness or temperature rise.

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 should stop and rest your joints.
2. In the subacute period. The pain syndrome decreases, mobility is restored, so you can slightly increase the intensity of the exercise and increase its duration. But you need to carefully monitor your well-being in order not to get worse.
3. In remission. We allow a full range of exercises for back pathologies, but it should be remembered that overloading is fraught with a new exacerbation of the disease.

If lumbar osteochondrosis is diagnosed with mild or moderate severity, treatment with physical education can also take place at home. After improving the training technique under the supervision of the trainer, it is forbidden to repeat the exercises at home. For the exercise, you will need a gymnastic mat, a roller and a ball.

Modern exercise therapy and rehabilitation rooms are equipped not only with traditional accessories, but also with special medical simulators. They help you recover from illness gently and safely, and make activities more fun and interactive. For example, the neuromuscular rehabilitation system makes rehabilitation an interesting competition with itself. 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 smallest improvements in the patient's condition. The system evaluates the result of each exercise performed and the doctor can see the progress from exercise to exercise. Knowing success also motivates patients to try harder and not give up.

Manual therapy

Good results can be achieved if you add exercise therapy and medication for back pathology with manual therapy. The method allows:

• eliminate hypertonicity of muscle fibers;
• relieve pain;
• restore blood supply in the lumbar and sacrum regions;
• improve the course of metabolic processes.

Manual therapy is an effective way to properly redistribute the load on the spine and protect yourself from future 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.  

Today, chiropractors combine physical therapy techniques such as massage and chiropractic. Electromagnetic waves penetrate deep bone tissue and allow to eliminate pain attacks and quickly restore mobility.  

Surgical methods

Osteochondrosis of the back, whose treatment is not always effective with drugs, physiotherapy and exercise therapy, significantly complicates the patient's life. In some cases, only surgical intervention is used to relieve pain and restore back mobility. Modern methods and technological equipment make it possible to perform minimally invasive operations with a shortened rehabilitation period.

The following methods of intervention are relevant for osteochondrosis:

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

Direct indications for surgical intervention are degenerative spondylolisthesis, which is repeated tears when the spinal canal is narrowed, spinal stenosis, and displacement of the vertebrae relative to each other. In all other cases, if osteochondrosis of the lumbar spine is confirmed, doctors try to treat it with conservative methods.

Disease prevention

The symptoms of osteochondrosis cause anxiety, and the treatment of the pathology may take a long time. It is more effective to protect the sensitive lumbar region from excessive strain beforehand. It is recommended for preventive purposes:

1. Organize your workplace properly during office work. The back of the chair should support the lower back, and the table should be appropriate in height.
2. Avoid uncomfortable shoes. The optimal heel height for women is up to 5 cm, it is also advisable to exclude flat heels, because they contribute to foot deformation and flat feet - one of the factors.
3. risk of osteochondrosis.
4. Exercise. Avoid lifting heavy objects. Swimming, walking and cardio exercises are useful if there are no contraindications.
5. Eat a balanced diet. The diet should include foods that are sources of calcium, phosphorus and B vitamins. These are fish, dairy products, leafy greens and cereals. These substances are necessary 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. This will ensure an anatomically correct posture where the body rests from daily stress.
7. Control your body weight. Obesity is one of the predisposing 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. Therefore, timely diagnosis is extremely important. If you are worried about back pain, and the images reveal destructive processes at the initial stage, you need to start treatment. Medicines and physiotherapy are effective in the early stages. In the following cases, it is rarely possible to do without surgery. Exercise therapy can be used as an additional aid measure in any form and at any stage.