What is osteochondrosis of the lumbar spine?

Osteochondrosis of the lumbar region is a pathology of the musculoskeletal system, which is accompanied by degenerative-dystrophic changes in the bone tissue and impairment of the function of the five lower vertebrae (20-24). The disease causes discomfort to 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. Left unattended, the 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 are no exact data as to why they cause degenerative-dystrophic changes in the spinal column. It can be assumed that the initial mechanism of the development of the pathology is changes in the joints related to early age. They can be genetically determined - they can be passed on through inheritance, but they are most often initially manifested as a result of unfavorable factors.

The main one is the incorrect distribution of the load on the spine. Osteochondrosis of the lumbosacral spine can develop:

• wearing high heels;
• carrying a bag or backpack on one shoulder without alternating;
• long periods of sleep or rest in an uncomfortable position;
• sedentary work;
• weight-lifting.

The risk of developing osteochondrosis includes the elderly, who are characterized by natural destructive changes in cartilage and bone tissue, professional athletes who train daily and intensively, and pregnant women, whose center of gravity shifts with the growth of the fetus and the load on the lower body. back increases significantly, office workers are forced to spend a lot of time in a sitting position.

In addition to external risk factors, doctors also name a group of internal risk factors. These are:

• previous injuries of the locomotor system;
• curvature of the spine;
• flat feet;
• 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 triggered by poisoning and prolonged dehydration, bad habits, calcium deficiency and any mechanical impact 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 spinal movement segment - vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Osteochondrosis of the lumbar spine develops, the symptoms of which become apparent gradually and slowly with significant damage. In the initial stage, moderate discomfort during training, in the later stages, acute, unbearable pain. Clinical symptoms are pronounced in the acute stage. They fade during the period of remission, and in the early stages this happens even without treatment.

Osteochondrosis of the lumbar spine - symptoms:

• pain in the affected area of the spine;
• radiation of pain upwards to the area of the shoulder blades or downwards towards the pelvis and hip joints;
• persistent feeling of tension in the lower back;
• difficulty in bending and turning the body;
• drive down;
• lameness;
• muscle weakness or, on the contrary, increased tone;
• tingling sensation.

Not all of the described symptoms always appear at the same time. Pain may be associated with limited movement, but not muscle weakness or numbness. Any of the signs discussed above are reasons to see a doctor.

Stages of the disease

The intensity of symptoms accompanying osteochondrosis of the lumbosacral spine directly depends on the degree of development of the pathology. There are four in total.

1. First stage. The first structural and functional changes begin. The intervertebral discs dry out and can crack. Symptoms at this stage are minor. Many patients confuse them with fatigue after a day at work, wearing uncomfortable shoes, or after exercising. The main signs of early osteochondrosis are mild discomfort in the lower back, which increases with bending and turning. Slight pain is possible, which goes away on its own after rest.
2. Second stage. The height of the intervertebral discs decreases, the bone structures move closer together. This triggers a new symptom - movement stiffness and pain. The pain becomes prolonged and intense and may radiate into the pelvis and legs.
3. Third stage. During this stage, the vertebrae are deformed. Protrusions are formed - the intervertebral discs bulge into the area of the spinal canal, but the fibrous rings remain intact. The main symptoms are intense, disturbing pain even at rest, reduced sensitivity, crunching and clicking during movement, tingling and numbness in the lower back.
4. Fourth stage. Pathological changes develop continuously. The functions of the vertebrae are lost. Hernias develop. Osteophytes - bone growths - are formed. Blood vessels can be pinched and nerve fibers can be pinched. Against the background of deteriorating blood circulation, the functioning of the pelvic organs is disturbed. The risk of erectile dysfunction increases in men, and menstrual cycle disorders can be observed in women. Advanced osteochondrosis manifests itself in sharp lumbago of the lower back, lameness, limited movement up to complete immobilization, and an increase in temperature.

If you are concerned about lumbar osteochondrosis, its treatment depends directly on the stage of diagnosis of the disease. In the early stages, the medic has many more recovery methods and techniques in his arsenal. Detection of degenerative-dystrophic changes at the initial stage allows conservative treatment of the pathology without surgical intervention.

Forms of pathology

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

1. Lumbago. It is an acute shooting pain that makes movement impossible. Pain can be caused by pinched nerves or muscle spasms.
2. Lumbodynia. It's a long-term, painful pain. It is characteristic of the stage of the formation of protrusions and hernias. The discomfort can also be associated with ligament sprains.
3. Sciatica. This is a severe pain that radiates 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 the pathology can be distinguished. The patient can be diagnosed with:

1. Radiculopathy. It is accompanied by compression of the nerve endings due to the deformation of the vertebrae. With this form of the disease, sensitivity decreases and the affected area becomes numb. Pain and a tingling sensation are expressed. Possible decrease in muscle tone, deterioration of reflexes, tingling in the legs.
2. Discogenic lumbar osteochondrosis. This is a serious condition in which the patient's movement is limited. His lower back and limbs were numb. Other symptoms are general weakness, fever, involuntary urination and, if the disease is prolonged, weight loss.

Risk of spinal disease

Without treatment, osteochondrosis is associated not only with unbearable pain and stiffness of movement, but also with many pathologies that can develop in the background. The most common complications are:

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

In order to prevent simultaneous pathologies, the treatment of osteochondrosis should be started immediately from the moment of recognition. With a competent approach to therapy, the destruction of bone and cartilage tissue can be stopped or significantly slowed down.

Pathology diagnosis methods

Osteochondrosis of the lumbar sacral spine must be distinguished from other pathologies of the musculoskeletal system, which may present with similar symptoms. The primary stage is a consultation with a neurologist, orthopedist or surgeon. The doctor clarifies the complaints, collects anamnesis, performs a physical examination, paying attention to the characteristics of the patient's posture and posture, the nature of his work activity, his bad habits, and accompanying diseases.

For the most accurate diagnosis, instrumental techniques are used:

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

All of the diagnostic procedures allow the doctor to assess the condition of the lumbar and sacral spine at the current moment. The images clearly show the structural changes of the vertebrae, indicating the stage of osteochondrosis. Based on the received data, the specialist makes a decision on the tactics of the patient's further treatment.

Laboratory diagnosis is not crucial, but studies are recommended in justified cases. 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 the inflammatory processes of the muscle fibers next to the spinal column.

Lumbar osteochondrosis: treatment

The fight against pathology takes place under the supervision of a neurologist and begins after a comprehensive diagnosis, when the extent and extent of tissue damage is determined. Modern medicine offers many effective conservative methods. If their use does not lead to the expected result, doctors resort to surgery.

Lumbar osteochondrosis: treatment with physiotherapy methods

All physiotherapy techniques are good because they have a comprehensive effect on the sacral and lumbar spine. This approach makes it possible to treat pain, reduce inflammation and restore normal blood circulation.

When osteochondrosis of the lumbar spine progresses, treatment should be comprehensive. Patients with complaints are prescribed:

• 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 with 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 of all, the effect of physiotherapy treatment can be noticed only after a procedure, the duration of which is selected individually for each patient. The second is that physiotherapy, as an independent method, works in the initial degree of osteochondrosis. In case of extensive lesions, it is recommended as an additional technique in addition to medical and surgical treatment.

Lumbar osteochondrosis: drug treatment

Pharmacotherapy of changes in the lumbar and sacral spine is aimed at alleviating acute pain and suppressing inflammatory processes. The method is relevant in the acute stage, when the symptoms interfere with the whole life.

The method of drug treatment of lumbar osteochondrosis is always decided individually. A neurologist can prescribe drugs from different pharmacological groups. Basic:

• NSAIDs (systemic and local) to reduce inflammation of the vertebrae and adjacent tissues;
• muscle relaxants to relieve muscle spasms;
• angioprotectors to improve blood circulation;
• chondroprotectors to protect the cartilage tissue of the intervertebral discs from destruction;
• B vitamins to improve nerve conduction;
• pain relievers for sharp shooting that restricts mobility.

Exercise therapy as a treatment method for the pathology of the sacrum and lumbar region

Intensive training for osteochondrosis is strictly prohibited, but physical activity cannot be completely abandoned. On the contrary, exercises of moderate intensity and duration help restore blood circulation and reduce pain.

Treatment of osteochondrosis of the lumbar spine with exercise therapy:

1. Train with an instructor. The instructor shows which exercises are allowed in a given situation and makes sure that they are performed correctly. Even the smallest technological errors can significantly reduce the effectiveness of training or even cause damage.
2. Prepare carefully for the lesson. It is recommended to warm up the muscles before training - you can gently massage the lower back and the sacrum.  
3. Strictly dose the load. The lower back is a vulnerable area. To avoid overload, you need to monitor the duration of classes. Their optimal duration does not exceed 20 minutes.
4. Gradually increase the intensity of your workout. Simple exercises and short programs are suitable for inexperienced beginners. For those who have been practicing therapy for a while, you can move on to more complex options.
5. Remember that it is regular. A one-time training does not bring visible improvement. Lumbar and sacral spine pain is reduced if the patient performs physical therapy regularly - ideally twice a week.
6. Note the contraindications. Physical therapy has been shown to be a safe method in the treatment of osteochondrosis, but it has limitations. You should stop training if you feel unwell: fever, weakness or a rise in temperature.

Lumbar osteochondrosis, the treatment of which should take into account the period of the disease, does 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. Pain syndrome decreases, mobility is restored, so you can slightly increase the intensity of training and increase its duration. But to avoid deterioration, you need to carefully monitor your well-being.
3. In remission. For pathologies of the lumbar spine, a full range of exercises is allowed, but it is important to remember that overexertion is associated with a further exacerbation of the disease.

If the lumbar osteochondrosis is of mild or moderate severity, treatment with physical education can be done at home. After perfecting the exercises under the supervision of an instructor, repeating the exercises at home is not prohibited. For training, you will need a gymnastic mat, a roller and a ball.

The 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 turns rehabilitation into an exciting competition with yourself. The patient stands on a moving platform and performs the exercises shown on the screen. Another important advantage of the simulator is that it can monitor even the smallest progress of the patient's condition. The system evaluates the results of each exercise performed, and the doctor can see the progress from exercise to exercise. The knowledge of success also motivates patients to try harder and not give up.

Manual therapy

You can achieve good results if you complement exercise therapy and drug treatment of lumbar pathology with manual therapy. The method allows:

• eliminates hypertonia of muscle fibers;
• relieves pain;
• restores blood supply in the lumbar and sacral areas;
• improves the course of metabolic processes.

Manual therapy is an effective way to properly redistribute the load on the spine and protect against further destructive changes. The good thing about this method is that it not only relieves pain, but also prevents neurological disorders, which often develop against the background of lumbar osteochondrosis.  

Currently, chiropractors combine massage and physical therapy methods, such as tecar therapy. Electromagnetic waves penetrate deep into the bone tissue and make it possible to alleviate pain attacks and quickly restore mobility.  

Surgical methods

Osteochondrosis of the lumbar spine, whose treatment with drugs, physiotherapy and exercise is not always effective, significantly complicates the patient's life. In some cases, only surgical intervention can be used to eliminate pain and restore back mobility. Modern methods and technological devices enable minimally invasive surgeries to be performed with a shorter rehabilitation period.

In the case of osteochondrosis, the following methods of intervention are relevant:

• 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 altered bone processes;
• microdiscectomy – removal of the protrusion of the hernia.

Direct indications for surgical intervention are recurrent hernia, spinal stenosis, when the spinal canal narrows, and degenerative spondylolisthesis, a pathology involving the displacement of the vertebrae relative to each other. In all other cases, if osteochondrosis of the lumbar spine is confirmed, doctors try to carry out treatment with conservative methods.

Disease prevention

The symptoms of osteochondrosis cause discomfort, and the treatment of the pathology can take a long time. It is much more effective to protect the vulnerable lumbar region from overload in advance. 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 of suitable height.
2. Avoid uncomfortable shoes. For women, the optimal heel height is no more than 5 cm. Flat soles should also be excluded, as they contribute to foot deformation and flat feet - this is one of the factors
3. risk of osteochondrosis.
4. Exercise. Avoid lifting heavy objects. Swimming, walking and cardio training 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 vegetables and cereals. These substances are necessary to strengthen all elements of the joints and to support the nervous system.
6. Make sure you get enough sleep. It is better to sleep on an orthopedic mattress of medium hardness. It provides an anatomically correct posture in which the body rests from daily stress.
7. Control your weight. Obesity is one of the provoking factors. With a normal body weight, the load on the spine is properly distributed and the risk of circulatory disorders is reduced to a minimum.

The prognosis of patients with osteochondrosis directly depends on the degree of damage to the vertebrae. Therefore, timely diagnosis is extremely important. If you are concerned about lower back pain, and the images reveal destructive processes in the initial stages, you need to start treatment. In the early stages, drugs and physical therapy are effective. In later cases, it can rarely be done without surgery. Exercise therapy can be used as an additional measure of help in any form and at any stage.