What is osteochondrosis of the lumbar spine?

Osteochondrosis in the lumbar region is a pathology of the musculoskeletal system, which is accompanied by degenerative-dystrophic changes in the bone tissue and dysfunction of the five lower vertebrae (from 20 to 24). The disease causes discomfort to the patient and is characterized by specific symptoms - pain, stiffness of movement. Osteochondrosis of the lower back develops in waves, with periods of exacerbation and remission. According to statistics, this form is one of the most common. Ignored pathology often leads to irreversible changes and significant deterioration of 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 on why degenerative-dystrophic changes occur in the spinal column. It is assumed that the initial mechanism of pathology development is premature age changes in the joints. They can be genetically determined - transmitted by inheritance, but most often they are initially manifested under the influence of unfavorable factors.

The most important among them is the incorrect distribution of the load on the spine. Osteochondrosis of the lumbosacral spine can develop:

• wearing high-heeled shoes;
• carrying a bag or backpack on one shoulder without alternating;
• sleeping or resting for a long time in an uncomfortable position;
• sedentary work;
• lifting weights.

At risk of developing osteochondrosis are the elderly, who are characterized by natural destructive changes of cartilage and bone tissue, professional athletes who exercise daily and intensively, pregnant women, whose center of gravity changes during the growth of the fetus and the load on the bottom. 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 call the internal group. This includes:

• previous injuries of the musculoskeletal 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 provoked by intoxication 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 segment of spinal movement - vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Osteochondrosis of the lumbar spine develops, the symptoms of which occur gradually and slowly with obvious damage. In the early stages, it is moderate discomfort during exercise, in the later stages - severe unbearable pain. Clinical signs are expressed in the acute stage. During the period of 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 spinal column;
• radiating pain above the shoulder blades or below the pelvis and hip joints;
• constant feeling of tension in the lower back;
• difficulty in bending and turning the body;
• Slouch
• lameness
• muscle weakness or, on the contrary, increased tone;
• tingling sensation.

All described symptoms are not always present at the same time. Pain may be associated with limited mobility but not accompanied by muscle weakness or numbness. Any of the signs discussed above will be a reason to consult 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. the first stage. The first structural and functional changes begin. Intervertebral discs wear down and can become cracked. Symptoms at this stage are insignificant. Many patients mistake them for fatigue after a working day, wearing uncomfortable shoes or exercising. The main signs of early osteochondrosis are mild discomfort in the lumbar region, which increases when bending and turning. Mild pain is possible, which will disappear by itself after rest.
2. the second stage. The height of the intervertebral discs decreases, the bony structures come closer to each other. This leads to a new round of symptoms - stiffness when moving and pain. The pain becomes prolonged and intense and may spread to the pelvis and legs.
3. the third stage. At this stage, the vertebrae are deformed. A herniation occurs - the intervertebral discs burst 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, cramping and clicking when moving, tingling and numbness of the lower back.
4. The fourth stage. Pathological changes progress. Spinal functions are lost. Hernia form. Osteophytes are formed - bony formations. Blood vessels and nerve fibers can be pinched. Against the background of deterioration of blood circulation, the functioning of pelvic organs is disturbed. In men, the risk of erectile dysfunction increases, in women there is a violation of the menstrual cycle. Advanced osteochondrosis is manifested by sharp lumbago in the lumbar region, lameness, decreased mobility to complete immobilization, and an increase in temperature.

If you suffer from lumbar osteochondrosis, its treatment will directly depend on the stage of diagnosis of the disease. In the early stages, the doctor has many more recovery methods and techniques in his arsenal. Detection of degenerative-dystrophic changes in the initial stages makes it possible to treat the pathology conservatively, 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. This is a sharp shooting pain that makes movement impossible. The causes of pain may be nerve compression or muscle spasm.
2. Lumbodynia. It is a long, agonizing pain. It is characteristic of the stage of formation of rash and hernia. Also, discomfort may be associated with ligament sprains.
3. sciatica. This is a severe pain that spreads to the pelvis. The patient complains of pain when walking, sitting or changing body position.

According to accompanying symptoms, two more forms of pathology are distinguished. The patient may be given the following diagnosis:

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

The danger of spinal disease

Without treatment, 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:

• intervertebral hernia;
• inflammation of the sciatic nerve;
• sciatica;
• Paresis.

In order to prevent accompanying pathologies, it is necessary to start treatment of osteochondrosis immediately from the moment of 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 differentiated 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 interprets the complaints, collects the anamnesis, conducts a physical examination, pays attention to the characteristics of the patient's posture and posture, the nature of his work activity, bad habits and concomitant diseases.

Instrumental techniques are used for the most accurate diagnosis:

• MRI;
• radiography;
• myelography with contrast agent;
• Multi-year CT.

Each diagnostic procedure allows 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, which indicate the stage of osteochondrosis. Based on the received data, the specialist makes a decision on the tactics of further management of the patient.

Laboratory diagnosis is not of key importance, however, if necessary, studies may be recommended. In particular, if lumbar osteochondrosis is diagnosed, treatment can be prescribed based on the results of a blood test. They are necessary to find out the intensity of inflammatory processes in the muscle fibers surrounding 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 degree and volume 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 affect the sacral and lumbar spine in a comprehensive way. 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. Patients with complaints are prescribed:

• Electrophoresis - exposure of the problem area to constant electrical impulses with the possibility of using medications for external use;
• diadynamic therapy - a variant of electrotherapy using impulse currents;
• Magnetotherapy - treatment with alternating or static magnetic fields;
• Ultrasound therapy - the influence of high-frequency sound waves;
• shock wave therapy - exposure to low-frequency acoustic impulses;

It is important to consider two nuances. First, the effect of physiotherapy treatment is noticeable only after a course of procedures, the duration of which is selected individually for each patient. The second is that physiotherapy, as an independent method, works for osteochondrosis of the initial degree. For extensive injuries, it is recommended as an adjunctive technique in addition to medical and surgical treatment.

Lumbar osteochondrosis: drug treatment

The pharmacotherapy of lumbar and sacral spine injuries is aimed at alleviating acute pain and suppressing inflammatory processes. The method is relevant in the acute stage, when the symptoms prevent a full life.

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

• Nonsteroidal anti-inflammatory drugs (systemic and local) to suppress inflammation in the spine and surrounding tissues;
• muscle relaxants to relieve muscle spasms;
• Angioprotectors to improve blood circulation;
• Chondroprotectors to protect intervertebral discs from destruction of cartilage tissue;
• B vitamins to improve nerve conduction;
• Analgesics for sharp shooting pains that limit mobility.

Exercise therapy as a method of treatment of sacral and lumbar region pathology

Intensive exercise for osteochondrosis is strictly prohibited, but physical activity cannot be completely refused. On the contrary, exercises of moderate intensity and duration 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 which exercises are permissible in a particular situation and will make sure that they are performed correctly. Even the most minor flaw in technology can significantly reduce the effectiveness of training or even cause harm.
2. Prepare carefully for the lesson. Before training, it is recommended to warm up the muscles - you can gently massage the lower back and sacrum.  
3. Strictly dosing the load. The lower back is a vulnerable area. To avoid overload, you should control the duration of 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 beginners without experience. For those who have been doing exercise therapy for some time, you can move on to more challenging options.
5. Remember to be regular. One-time training will not bring visible improvement. Pain in the lumbar and pelvic spine is reduced if the patient regularly performs exercise therapy - optimally twice a week.
6. Consider the contraindications. Physiotherapy has proven to be a safe method for helping osteochondrosis, but there are limitations. You should stop exercising if you feel unwell: fever, weakness or fever.

Lumbar osteochondrosis, the treatment of which should take into account the period of the disease, will not bother you if you strictly follow all the rules.

1. in the acute period. Only smooth and slow movements are allowed. If the pain increases during exercise, it is necessary to stop and rest the joints.
2. in the subacute period. Pain syndrome disappears, mobility is restored, so you can slightly increase the intensity of exercise and increase its duration. But, to prevent deterioration, you need to carefully monitor your well-being.
3. during remission. We allow a full range of exercises for lumbar spine pathologies, but it is important to remember that excessive load is fraught with new exacerbations of the disease.

If lumbar osteochondrosis is diagnosed as mild or moderate, treatment with physical education can be carried out at home. After perfecting the exercise technique under the supervision of the instructor, repeating the exercises at home is not prohibited. For training, 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 turns rehabilitation into an exciting competition with yourself. The patient stands on a moving platform and performs the exercises presented on the screen. Another important advantage of the simulator is the ability to track 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. Knowing their own success also motivates patients to try harder and not give up.

manual therapy

Good results can be achieved if you complement exercise therapy and medications for lumbar pathology with manual therapy. The method allows:

• elimination of hypertonicity of muscle fibers;
• pain relief;
• restores blood supply to the waist and pelvis;
• Improves the course of metabolic processes.

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

Currently, chiropractors combine massage and physical therapy methods such as tekartherapy. Electromagnetic waves penetrate deep into bone tissue and allow you to relieve pain attacks and quickly restore mobility.  

Surgical methods

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

The following intervention methods are appropriate for osteochondrosis:

• Endoscopic excision of intervertebral hernia - using microsurgical instruments and a built-in camera;
• Removal of intervertebral hernia with transfacet - using neurosurgical tube expanders;
• Laminectomy - surgical removal of pathologically changed bone processes;
• Microdiscectomy - elimination of hernia protrusion.

Direct indications for surgical intervention are recurrent hernia, spinal stenosis, when the spinal canal narrows, and degenerative spondylolisthesis, a pathology in which the vertebrae are displaced 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 inconvenience and the treatment of the pathology can take a long time. It is much more effective to protect the vulnerable lumbar area in advance from excessive load. For preventive purposes, it is recommended:

1. Properly organize your workplace during office work. The back of the chair should support the lower back, and the table should be suitable for the height.
2. Avoid uncomfortable shoes. The optimal height of the heel for women is up to 5 cm, it is also advisable to exclude flat soles, because they contribute to foot deformation and flat feet - one of the factors.
3. Risk of osteochondrosis.
4. exercise. Lifting heavy objects should be avoided. 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, such as fish, dairy products, leafy greens, and grains. These substances are needed to strengthen all elements of the joints and to support the nervous system.
6. Make sure you get adequate sleep. It is better to sleep on an orthopedic mattress of medium density. It provides an anatomically correct posture in which the body rests from daily stress.
7. Control your body weight. Obesity is one of the provoking 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 of patients with osteochondrosis directly depends on the degree of damage to the spine. Therefore, timely diagnosis is very important. If you suffer from back pain and the images reveal destructive processes in the initial stage, you should start treatment. In the early stages, medications and physical therapy are effective. In later 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.