A significant mass of a person falls on the lower back, and when the load is raised, twisted, from a long static position, additional stress is created in it. Excessive load, wrong lifestyle steadily leads to degradation of the musculoskeletal system: the vertebrae and discs between them, which function as shock absorbers. From this point on, it is worth looking for information about osteochondrosis of the lumbar spine: symptoms and treatment. Why do degradation of the joints of the spine occur?
The degradation of the musculoskeletal system occurs as follows: the natural shock absorber of the spinal column loses its elasticity, contracts, spreads beyond its natural limits, and the pressure from other vertebrae, organs, ligaments additionally increases. Let us describe those who are prone to acquiring such a pathology. Osteochondrosis of the lumbar spine can be observed in people:
- Whose early generations suffered from a similar affliction;
- Having hormonal disorders;
- Individual propensity to develop such diseases (for example, congenital structure of the spine);
- Those who neglect proper nutrition. On the table every day a person should receive a balanced diet with healthy fats, vitamins, proteins;
- Those who have sedentary work: sit for a long time or stand for a long time in one place;
- Experiencing a sharp and heavy load on the spine, for example: weightlifters, loaders, people during garden work;
- Having diseases of digestion, metabolism, pelvic organs;
- Traumatized (pulled too hard on the back, hit sideways, fell, bent over);
- Have reached the age of 30;
- Diabetes.
If there are signs of lumbar osteochondrosis, which are described in the section below, then some habits should be avoided:
- slouch;
- smoke;
- take a bent pose for a long time;
- move a little;
- drink alcohol;
- to sit without taking breaks at work;
- dress not for the weather, allow the body to cool.
Important. Any disorders in the ligaments are aggravated by the presence of excess weight. With excess weight, the load on the lower body increases, and the lumbar region, overgrown with fat, is heavily massaged.
Stages of the course of the disease, its signs
At first, there are periodic mild pains that increase with physical exertion. This discomfort hints that it's time to pay attention to osteochondrosis of the lumbar spine. Right now, the intervertebral discs (the disc of the spine is the channel through which the spinal cord and the fibrous ring around it) are degrading. Further, the distance between the vertebrae is reduced, the nerves are pinched. The pains become severe, seize not only the back, but also the hips, gluteal muscles. In the third stage, the fibrous rings are destroyed, which leads to the formation of a hernia of the spine, irreversible stoop, and pain is constantly present. The fourth stage leads to disability. Special classification of osteochondrosis of the lumbar spine includes:
- pain;
- ischemic syndrome;
- radicular syndrome;
- vertebral syndrome;
- ossification of overgrown tissues.
Pain sensations have a different degree and character of severity: lumbago, for example, is called lumbago; constant, aggravated by stress, lumbodynia; Spreading along the lower parts of the body are called lumboischialgia. In the case when back illnesses are not dealt with, the vertebrae acquire too much free movement in the spinal column. There is a compression of the nerve roots when lifting loads and abrupt actions, then the pain from the lower back goes away, but moves to other parts of the body, for which the nerve is responsible. Unconsciously, we change position, adjusting so that there is less pain in the back, but this inevitably changes the gait and bend of the spine. All this refers to the radicular syndrome, which begins as irritation, and then becomes inflammatory. Signs of osteochondrosis of the lumbar spine with radicular syndrome:
- Back muscles are excessively tired;
- change of back bend;
- gait changes;
- swelling of the lower extremities;
- pain in one or both legs;
- severe pain;
- temporary loss of sensation in the legs;
- periodically long constipation;
- men have problems with excitability;
- menstrual irregularities in women;
- intoxication of the body;
- blood stagnation.
You can notice that during breaks, painful sensations arise, and when doing exercises on the back, they subside. Already at this stage it is worth looking for a doctor: chiropractor, surgeon, neurologist, traumatologist (since the causes of osteochondrosis of the lumbar spine include trauma). If you let the disease take its course, the problem will increase, supplemented by different companions:
- heat;
- numbness;
- sweating;
- tingling;
- chills;
- goosebumps;
- impotence;
- intestinal colic.
Back muscles lose their tone, and this leads to a general loss of human motor functions. With a particularly dangerous course of the radicular syndrome, paralysis will occur. Ischemic syndrome is associated with radicular. At first, squeezing of blood flows is periodic, but then such squeezing leads to spasms. You can notice them during normal walking - you walk in pain, if you stop, it does not hurt. The main degradation occurs inside and is not visible to the naked eye - the blood flows do not provide all the pelvic organs with the necessary supply. Painful sensations of the buttocks, thighs may occur, subsequently paralysis of the gluteal muscles may occur. Vertebral syndrome includes a change in the skeleton, the blood vessels themselves.
Important. Symptoms of lumbar osteochondrosis in women are inextricably linked with the hormonal background, the physiological characteristics of the body. The occurrence of pain, improper posture is influenced by the wearing of unsuitable shoes: on too hard or too soft soles; too high a heel or too low a heel.
Diagnostics of the stages of the disease
It can be very difficult even for a doctor to classify and name the stage of the disease during external examination. Initially, a neurologist can diagnose:
- persistent curvature of the spinal column;
- pain when touching;
- decreased leg travel;
- asymmetry of the gluteal zone;
- change of Michaelis diamond.
But the most accurate diagnosis can only be made with the results:
- computed tomography (CT). The most optimal option for determining the degree of development of the disease, allowing to assess the stage of degradation of the spinal column.
- X-ray filming. According to them, it is possible to establish the presence of an ailment, but it is not always possible to determine the degree of development of damage to nerve fibers and blood vessels.
- magnetic resonance imaging. Quite a long (from half an hour to an hour), an expensive procedure, which additionally provides the most complete detail of what is happening with the nerve roots and blood vessels.
Thus, the doctor can finally judge about osteochondrosis of the lumbar spine: symptoms and treatment only with the results of apparatus research. Low back pain that is not associated with a disorder of the intervertebral disc is caused by colds, chill kidney, menstrual cycle, or back pain.
Important. CT, X-ray examinations are unacceptable for pregnant women. CT is unsafe for: 1) children under 14; 2) people with iodine allergy.
Medical treatment
The causes of the onset of the disease, its characteristics are considered above, now we turn to the second point of osteochondrosis of the lumbar spine: symptoms and treatment. The longer you ignore the signals of the body, the faster the disease will go further. The further from the beginning, the more medicines and procedures will have to be applied. Treatment objectives:
- identify, eliminate the causes of pinching of the roots, blood vessels of the spine;
- restore the sensitivity of the skin;
- to prevent further development of pathology;
- start the body's processes for self-healing;
- strengthening a person's muscle tone;
- restore the function of the internal organs of the small pelvis;
- return the normal course of the lumbar vertebrae.
If you experience any discomfort, see your doctor. The first thing to do at the first symptoms is to pay attention to: a bed (a wide selection of orthopedic mattresses that must be selected individually), a pillow (may not suit you in size or softness), position during sleep, motor activity. At home, without being examined by a doctor, osteochondrosis of the lumbar spine is treated only with bed rest. Therefore, a visit to a doctor is mandatory. In the stage of remission and the acute phase of the disease, different medications are taken. In the last phase, drugs are used to relieve pain, release nerves from vertebral mites, and eliminate inflammation. Prescribe: - blockades; - glucocorticoids; - chondroprotectors; - myo-laxatives; - non-steroidal anti-inflammatory drugs (NSAIDs).
The last group of drugs, in addition to pain relief, fights against excessive body temperature, edema, inflammation. Such funds can be: rectal, for internal use, injection, external. Treatment of osteochondrosis of the lumbar spine most often begins with NSAIDs:
- Diklofenak;
- Piroksikam;
- Ibuppofen;
- Himeculide;
- Hapoxy;
- Decketoprofen;
- Meloksikam;
- Aceclofenac.
The anti-inflammatory drugs on this list are various ointments, tablets, gels. Some tableted NSAIDs have contraindications for those with ulcers or gastritis. Muscle relaxants relieve joint stiffness and involuntary contractions of the back muscles by temporarily reducing muscle tone. This group of drugs includes tizanidine, tolperisone hydrochloride. When there is an opportunity to save the intervertebral disc, chondroprotectors are prescribed, which should serve to restore the annulus fibrosus. The course of taking such a group of drugs is very long - at least 1. 5 months, and the results can be seen only after a year. They try to avoid the appointment of glucocorticoids, since they have side effects of taking them, since this group of drugs belongs to steroid hormones. They must be taken under the supervision of the attending physician with the fulfillment of all the prescriptions, since only a specialist knows how to cure lumbar osteochondrosis. An example of such a drug is hydrocortisone. Blockages are not medications in and of themselves, but they are a powerful local pain reliever. The technique is as follows: the introduction of an injection pain reliever (IO) or a combination of IO with a drug from the group of glucocorticoids in the area of pain. Blockades have no medicinal properties, but they can be addictive, which will lead to a loss of sensitivity to these drugs. If injected frequently, the muscles around the injection may atrophy. Therefore, when acute pain is reduced by this method of treatment, the patient is prescribed medications that are designed to restore damaged tissues, blood flow, and help improve muscle and nerve fiber tone. This:
- The chondroprotectors, which have a general strengthening effect on the bone tissue, normalize the metabolism of cartilaginous tissues.
- Vitamins that help restore nerve patency.
- Biogenic preparations that encourage the body to heal itself;
- Vascular medications that thin the blood to improve the nutrition of the internal organs.
During treatment, along with the main intake of medications, antidepressants are prescribed. Here's how to treat low back pain during acute pain relief:
- apply warming, analgesic, anti-inflammatory external agents;
- do special exercises for the back;
- go for a massage;
- lead a gentle lifestyle for the back;
- put on a belt corset when exercising.
Massage, exercise therapy, physiotherapy and alternative treatments.
Comparatively cheap, effective methods of combating shock absorber degradation are physiotherapy exercises, massage, physiotherapy. A real massage can only be done by a professional with a medical education, so a simple visit to beauty salons is not suitable for patients. Each stage of the disease requires a different pressure and technique. With proper therapy, muscle spasm disappears, the muscular frame of the back is strengthened, and the pain gradually disappears. Physiotherapy is applicable only in the process of attenuation of painful processes or when they are absent (to maintain the mobility of the vertebrae). Gymnastics is selected individually, based on the age, condition of the person, stage of development of the disease. The productivity of therapeutic exercises directly depends on the quality of performance and frequency: they must be done systematically. It is recommended to rest at home, lying on your back, bending your legs, placing a small roller under your lower back. The healing process is monitored with the help of X-ray, tomographic surveys. Physiotherapy treatments are prescribed during remission and exacerbation. Methods such as:
- acupuncture. An ancient method of treating pain, based on the stimulation of acupuncture points with fine needles. The procedure relieves spasms, reduces pain, completely eliminates it, reduces tissue edema;
- ultraviolet irradiation, which stimulates the body to absorb calcium;
- ampilpus, named from the corresponding device. The treatment procedure is as follows: the plates of the apparatus are fixed on the back, and the corresponding therapeutic current with different parameters flows through the plates;
- laser therapy. Laser beams relieve pain, heal, stop inflammation in the lumbar vertebrae;
- darsonvalization. The method is designed to improve blood circulation, dilate blood vessels, stimulate nerve endings;
- phonophoresis treats with ultrasound, stimulating blood flow to the muscular part of the dorsal region.
Each method has its own contraindications. It is more difficult with traditional medicine. Official medicine does not recognize that midwives' grandmothers know how to treat lumbar osteochondrosis. Therefore, if a friend advises you to apply compresses made with burdock broth, take coniferous baths, you should consult your doctor. For pain relief, a method such as hirudotherapy is used, but leeches are hidden behind this name, so doctors advise to approach this method of treatment with caution.
Surgical problem solving
In some cases, it is no longer possible to do without surgery. With advanced intervertebral hernia, neurosurgeons use microdiscectomy. The operation removes the damaged disk. If there are no contraindications, then doctors can perform nucleoplasty, which has many advantages:
- Does not require cuts;
- The operation takes up to 30 minutes;
- No restrictions as for surgical procedures.
Important. To maintain mobility of the spine, strengthen the muscles of the back, it is recommended to do yoga, swimming, Pilates. Running produces a shock load on the vertebrae, so at the first sign of lower back pain, you should refuse to run.