Osteochondrosis of the lumbar spine.

One of the most common diseases today isosteochondrosis of the lumbar spine. Both men and women go to doctors with this disease with the same frequency.

At least once in our lives, each of us has experienced pain in the lower back, sacrum or lower extremities. We often unknowingly call this type of pain "pinched nerve in the lower back. "

Causes of lumbar osteochondrosis.

According to research by doctors and scientists, the main cause of osteochondrosis of the lumbar spine is upright posture. However, not all people suffer from osteochondrosis. Provoking factors that accelerate the development of the disease are: metabolic disorders, physical inactivity, injuries, excess weight, improper weight lifting.

The source of pain in osteochondrosis is pinching of the nerve roots, which occurs after protrusion of the intervertebral disc and narrowing of the intervertebral space. This deviation is formed when nutrition deteriorates, the natural processes of oxygen and lymph exchange in the tissues of the intervertebral discs are disrupted. As a result, the shock absorption capacity of the intervertebral discs decreases, and the nucleus pulposus of the disc gradually decreases and dries out.

From an anatomical point of view, lumbar osteochondrosis is a process of transformation of cartilage into bone, which results in excessive pressure on the nerve roots extending from the spinal cord. This change causes pain. Excessive growth of bone tissue occurs due to deterioration in the nutrition of the intervertebral discs, loss of fluid and disturbances in structure and function.

When the protrusion of the intervertebral disc during the development of osteochondrosis of the lumbar spine becomes more severe, it causes the development of lumbar protrusion and herniation of the lumbar disc due to rupture of the annulus fibrosus.

Pain syndrome is formed due to pinching of the spinal nerve in lumbar osteochondrosis and is called lumboischialgia. This symptom is accompanied by numbness of the lower extremities. Depending on the nature and location of the pain, the disease can be divided into sciatica and lumbago. Inflammation of a nerve due to pinching is called radiculitis. Methods of treating radiculitis with analgesics, in fact, are only the elimination of symptoms and are ineffective, because such treatment does not affect the true cause of the disease, that is, the degenerative processes in the intervertebral discs. To eliminate pain and take preventive measures to prevent complications, it is necessary to undergo comprehensive treatment to activate restoration processes in the tissues of the discs, normalize the height and physiological parameters of the intervertebral discs.

Symptoms of osteochondrosis of the lumbar spine.

One of the signs of osteochondrosis is compression of the spinal nerve roots by the nucleus pulposus protruding from the intervertebral disc. This compression occurs in the epidural space, which is a kind of container for the spinal roots. Osteochondrosis of the lumbar spine is manifested by the following symptoms that correspond to a compressed root:

• L1 and L2: loss of sensitivity in the "rider's pants" area, that is, in the groin area and inner thighs. Pain can occur in both legs at once if lumbar osteochondrosis is complicated by the development of a hernia.
• L5: stabbing pain, decreased sensation in the lower back and sensitivity of the thumb, as well as decreased ability to flex the finger.
• S1: stabbing pain, decreased sensation in the lower leg and outer thigh, pain in the foot from the little toe to the fourth toe. Often when this root is damaged, the plantar and Achilles reflexes are lost.
• Damage to the Deproge-Gotteron artery - in the chronic course of osteochondrosis, paralysis of the lower leg and buttocks may occur and sensitivity in the anogenital area may disappear.
• Simultaneous damage to the L5, S roots and the Deproge-Gotteron artery causes the "paralyzing sciatica" syndrome, loss of pelvic and motor functions.

Osteochondrosis of the lumbar spine can lead to bulges and hernias due to significant loads on this part of the spine. It is these complications that develop very quickly, so it is very important to treat them in a timely manner. Do not delay visiting a vertebrologist, have a complete examination and seek qualified help at the first symptoms of lumbar osteochondrosis.

Complications of osteochondrosis of the lumbar spine.

Vascular ischemia due to compression can be considered a complication of lumbar osteochondrosis. This pathology develops due to a violation of the blood supply to the spinal cord, a reduction in the intervertebral openings for vessels and arteries, as well as a narrowing of the peripheral structures of the vertebrae. The reason for the development of this pathology is the flattening of the discs, excessive mobility of the spine, weakening of the ligaments, the formation of osteophytes and neoatrosis. Permanent injury and pressure occurs on a pinched vessel or artery due to any movement of the spine that affects the damaged area. Additionally, a reflex narrowing of the vessel passing through the canal opening may develop. This effect is called "narrow bed. "

Vertebralogists identify another serious complication of osteochondrosis of the lumbar spine. Compressive myelopathy is a spinal cord disorder that occurs due to narrowing of the spinal canal. Depending on the location, the symptoms and severity of the pathology may vary. Most often, the course of the disease is characterized by episodicity: after an attack there is a period of remission.

Lumbar osteochondrosis can be complicated by a TXII-L1 disc herniation, which puts pressure and causes damage to the S1-S2, L2-L-4 segments of the spinal cord. A patient with this complication feels pain in the lower back, lower leg, back of the thigh, and weakness in the legs. The gluteal and calf muscles gradually become hypotonic and hypotrophic, the plantar and Achilles reflexes disappear, and foot paresis forms. The back and outer surface of the foot and lower leg are characterized by reduced sensitivity or its complete absence.

If a LI-II disc herniation develops, in which excessive pressure on the S3 coccygeal segment increases, osteochondrosis of the lumbar spine has the following symptoms: disturbance of the pelvic organs, fecal and urinary incontinence, constipation, loss or decreased sensitivity of the anogenital area, development of bedsores, anal prolapse reflex.

"Caquina equina syndrome" develops when nerve roots become compressed from the first lumbar vertebra downward. An experienced vertebrologist notes that this syndrome most often develops in patients with congenital narrowing of the spinal canal. The "cauda equina" is a bundle of nerve roots that contains the terminal roots of the spinal cord from the first segment onwards. The name arose from its resemblance to a horse's tail. The diagnosis of this syndrome largely depends on the presence of unbearable pain of a radicular nature. It is this feature that distinguishes cauda equina syndrome from other complications in which there is no acute pain.

Cauda equina syndrome is characterized by severe pain in the sacrum and lower back, radiating to the buttocks, anogenital region and the posterior surface of the thigh. In some cases, paresis, peripheral paralysis and sensory disorders occur. Severe cases are characterized by paralysis of the buttocks and both legs. A characteristic feature of the complication can be considered the asymmetry of sensory and motor disorders.

Lumbar osteochondrosis can lead to the development of the myelogenous syndrome of "intermittent claudication", in which there is weakness in the legs when walking, frequent urge to urinate, and numbness in the lower torso. The cause of this discomfort is poor blood supply to the lower parts of the spinal cord. After rest, these sensations disappear.

With ischemia of the cauda equina roots, caudogenic "intermittent claudication" occurs: goosebumps and a tingling sensation when walking. Over time, this symptom can increase and reach the perineum, genitals, and groin. Weakness in the legs disappears after a short rest.

Compression of the Adamkiewicz artery can occur due to sudden failed movements, heavy lifting, or shaking. This complication of osteochondrosis of the lumbar spine manifests itself as disorders of the pelvic organs, loss of sensitivity, the appearance of bedsores and atrophy of the leg muscles.

Osteochondrosis of the lumbar spine is manifested by pain in the lower back. Due to prolonged stay in an uncomfortable position, the pain may intensify. After sleeping or resting in a supine position, the pain subsides or disappears completely.

The appearance of stressful situations for the body can cause the development of an acute condition. Most often this happens during hypothermia, heavy loads and sudden movements. An exacerbation is characterized by intense pain, which from the lumbar region can descend to the legs. The body can independently try to reduce the load on the affected part of the spine by strong tension on the lumbar muscles. A patient with osteochondrosis of the lumbar spine tries to find a comfortable position in which the pain disappears.

Diagnosis of lumbar osteochondrosis.

The diagnosis of osteochondrosis is made in several stages. The doctor needs to talk to the patient, ask him about his complaints, find out the nature of the pain, where it is located, at what time the painful sensations are felt, their duration, intensity, etc. Additionally, the doctor will find out under what conditions the pain appears, when it intensifies or subsides.

After this, the vertebrologist examines the anamnesis, i. e. history of the disease. The doctor will definitely clarify how long the painful condition lasts, what was the cause of the pain and how you feel during the period when the discomfort disappears. An important point is preliminary treatment, as well as the effectiveness of certain treatment methods. A qualified doctor will definitely ask the patient about living and working conditions, range of motion, well-being under certain loads and past illnesses. It is very important to know if the patient had spinal injuries, if he played sports and if any immediate family member had spinal diseases.

The next step in the diagnosis will be the examination of the patient. The doctor will pay attention to the position of the head, legs and arms in relation to the body, the way of walking, the way of holding oneself, the symmetry of the areas of the body, the condition of the skin in the damaged area and the patient's movements. After this, the spine's range of motion and damage level are set. To do this, the doctor will ask the patient to lean forward, sideways, backward, ask him to move different parts of his back and tilt his head. A healthy person should not experience any cracking or joint pain during such a simple test.

If the patient does not suffer from osteochondrosis, then he can reach the chest and shoulder with his chin. Head movements in each direction are about 60 degrees. A 45-degree angle is formed by leaning sideways between the head and the upper cervical spine. The distance from the sacrum to the spinous process of the seventh cervical vertebra increases by 5 to 7 centimeters when leaning forward. This distance is reduced by 5 to 6 cm when leaning back. An experienced vertebrologist will pay attention to how the knee and hip joints participate in flexion and how the configuration of the spine changes.

Treatment of osteochondrosis of the lumbar spine.

Lumbar osteochondrosis requires complex, intensive and long-term treatment. This is especially true in chronic cases with multiple hernias and intervertebral protrusions.

Effectivetreatment of osteochondrosis of the lumbar spineIt is achieved through reflex methods that do not cause side effects, but bring maximum benefit. Remember, recovery from such a serious illness cannot come quickly. In each case of lumbar osteochondrosis, the doctor prescribes an individual treatment regimen.

It is worth noting that manual therapy can only be used in cases where the patient's spine is not damaged by intervertebral protrusions and hernias. The integrated use of these techniques makes it possible to restore normal blood microcirculation, eliminate congestion, vascular edema, relieve muscle spasms, restore the balance of metabolic processes in the tissues of the vertebrae and intervertebral discs, and also improve the nutrition of the tissues in the lumbar region. As a result, the natural regeneration process is stimulated. It is worth noting that in case of lumbar osteochondrosis, manual therapy should be aimed at improving the functions of the spine.

Lumbar osteochondrosis treatment procedures are complemented by the use of herbal remedies that improve the innervation of the body, and also restore the balance of metabolic processes. The vertebrologist will recommend nutritional correction and a more active lifestyle to patients. It is important to adjust body weight, because excess weight puts additional pressure on the lower back and also aggravates the development of osteochondrosis of the lumbar spine.

An experienced specialist treating osteochondrosis allows the patient to achieve serious results, as well as avoid surgery, improve motor activity, eliminate lower back pain and comprehensively improve the body to prevent new exacerbations. Acute pain disappears after 1 to 3 sessions of manual therapy and the positive effect of treatment is achieved on average after 10 to 15 sessions. Remember that the timely start of treatment is a guarantee of achieving positive results.

During the period of exacerbation of low back pain, the patient is recommended to stay in bed for 2-3 days. To quickly relieve pain, non-steroidal anti-inflammatory drugs, analgesics, venotonics, diuretics, nicotinic acid and vitamin B are prescribed. Walking with crutches, dry or underwater spinal traction may also be prescribed to unload the spine. If necessary, glucocorticoid blocks or paravertebral blocks with an anesthetic are prescribed.

Physiotherapeutic treatment of osteochondrosis of the lumbar spine may also include electrophoresis, laser therapy and ultraviolet radiation. Physiotherapy is a mandatory component of a comprehensive treatment program. Some exercises can be used in the acute stage, but it is recommended to perform almost all exercises after the pain has subsided. Thanks to regular physical exercise, tissue nutrition is restored, the blood and lymph supply to the intervertebral discs is improved, and the flexibility and elasticity of the joints and cartilage is gradually restored. Therefore, the patient's condition improves and the interval between periods of exacerbation lengthens.

Spa treatment also has a good effect on health. In climatic resorts, iodine-bromine, hydrogen sulfide and radon baths are prescribed.

Surgical treatment methods are used only if the patient's pain cannot be relieved with conservative methods for a long time, with paresis of the muscles of the lower extremities and disruption of the natural processes of urination and defecation. During the operation, the herniated disc is removed and the spinal segment is strengthened.

Prevention of lumbar osteochondrosis.

Prevention of lumbar osteochondrosis consists of following a few simple rules recommended by a vertebrologist. Remember that the development of the disease can be prevented only by carefully following these rules, no matter what:

• Keep your lower back dry and warm, do not cool your spine too much, and avoid drafts.
• Do not lift heavy objects or carry them long distances.
• Try not to make sudden movements.
• Maintain correct posture when working and resting.
• Change positions as often as possible, trying not to stay in one position for too long.
• Do physical therapy.
• Try not to stay in a bent position for a long time.
• When cleaning, use long mops, a broom, and a vacuum cleaner with a long wand so you don't have to bend over.
• Lift weights correctly: bend over with your back straight, or bend your knees, lift the bags with your back straight, and stand up straight. Keep your hands with the load as close to your body as possible.
• If you need to bend down to pick up something from the floor, such as under a table or bed, kneel and keep your back straight.
• Distribute the weights equally between two hands.
• Strengthen your gluteal muscles, stretch your spine, go for a walk every day.
• Balance your diet, enrich your diet with dairy and vegetable products.
• Follow the drinking regimen: 1. 5 to 2 liters of water and infusions per day.
• Get rid of bad habits: alcohol, smoking, drugs.