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What is osteochondrosis of the lumbar spine?
Osteochondrosis of the lumbar spine – This is a disease that is a special form of damage to the spine. Patients with this disease complain of fatigue, pain in the back, legs, which causes limitation of motor activity. With osteochondrosis, deformation of the intervertebral discs occurs, a decrease in their height, dystrophy and coracoid growth of the vertebrae are observed. When diagnosing, the disc displacements are clearly visible on the radiograph.
Cartilage tissue deformation during the development of osteochondrosis is a complex process, including biochemical and vascular changes. First of all, the destruction of the fibrous ring occurs, as a result of which the pulpous is introduced into it. As a result, the annulus fibrosus ruptures and a disc herniation is formed. In this case, the lower cervical and lower lumbar segment is subjected to the greatest load. A herniated disc, squeezing the spinal cord or its roots, causes back pain that radiates down the leg.
The most powerful sciatic nerve in the human body is formed by the sacral roots of the spinal cord. It is they, as well as the lower lumbar roots, that are irritated with osteochondrosis. From the Latin name of the sciatic nerve, in connection with this, the second name of the disease, sciatica, was formed.
Due to a violation of the structure of the cartilage tissue, the intervertebral discs, which are special cartilage structures, can no longer perform all their functions in full. This leads to loss of flexibility and mobility of the spine. Processes that at the initial stages of the disease affect only the intervertebral discs gradually spread to the vertebrae themselves.
Discogenic sciatica, which is considered one of the most common symptoms of osteochondrosis, occurs in almost every fifth person over 30 in the world. People of working age are most often at risk. Osteochondrosis deprives the ability to engage in vigorous activity and often becomes the cause of disability.
Lumbar osteochondrosis symptoms
The main symptom of lumbar osteochondrosis is severe back pain. However, in addition to this feature, there are a number of others. So, patients suffering from this disease quickly get tired, complain of headaches, fatigue and irritability. Discomfort in the back area does not allow you to choose a comfortable position for sleeping, so the body cannot fully relax and recover after the end of the day. The loss of energy forces the patient to minimize physical activity and avoid pain. This leads to the fact that over time he becomes unable to perform even simple actions, for example, to provide for his own household needs.
Problems in the functioning of the genitourinary system can also be one of the symptoms of lumbar osteochondrosis. They manifest themselves in the form of pain in the kidney area. In patients with osteochondrosis, urination is disturbed, an unexpected occurrence of unreasonable discomfort is possible. This leads to instability of the vertebrae, which, due to deformation, are not fixed by the intervertebral discs. The load on the spine provokes the displacement of the lumbar region from the sacrum when gravity acts on it. This process leads to damage to internal organs, problems in their work. In women, the ovaries, appendages and uterus are most often affected, while in men potency is impaired.
Osteochondrosis is characterized by an increase in the sensitivity of the legs, including the feet, thighs and lower legs. Spasms occur in them, which can lead to a complete loss of pulse. The skin of a patient with osteochondrosis on the legs is very dry, flaky and covered with goosebumps in the area of discomfort. During attacks of pain, sweating is disturbed.
All symptoms of osteochondrosis can be classified into the following groups:
radicular syndrome
The thinning of the intervertebral discs leads to the loss of stability of the vertebrae. Having become mobile, with sudden movements and heavy physical exertion, they begin to get irritated and squeeze the blood vessels and nerve roots. This process minimizes pain in the lumbar region, but they resume with renewed vigor where the nerve is compressed. The pain is sharp and has a boring character. The most severe discomfort is expressed in the lower leg, thigh, foot and buttock. Unpleasant sensations force the patient to change his gait, bending in the opposite direction from the compressed nerve.
When the nerve roots are irritated for a long time, their inflammation, swelling, venous congestion and intoxication occur. The pain spreads to the muscles, ligaments. It is most acute at times of physical exertion, especially if it is carried out without a warm-up immediately after sleep or a state of rest. The pain is often accompanied by increased sweating, which is replaced by a feeling of chills.
Symptoms of radicular syndrome also include tingling, numbness, and loss of sensation. Muscles lose their tone, so patients become unable to endure prolonged physical activity, such as going down and up stairs, and get tired quickly. The functions of the small pelvis are violated in especially severe cases. In this case, even the occurrence of paralysis and paresis is possible.
Ischemic syndrome
Near the nerve roots are blood vessels, which are compressed during deformation. At the first stages of the development of osteochondrosis, the arteries are compressed periodically, but then the spasm becomes permanent. In this case, “intermittent claudication” occurs, the patient, when walking for a long time, often needs to stop and rest.
Compression of the blood vessels leads to the fact that the pelvic organs do not receive the necessary nutrients. This causes pain on the inside of the thighs, perineum, in the buttocks up to their paralysis.
Vertebral Syndrome
Under the influence of pain, ischemic and radicular syndrome, the skeleton of a patient with osteochondrosis is deformed. A person begins to stoop, his pelvis and spine warp, muscles weaken, atrophy. All these changes affect the gait, which is corrected depending on the area of pain, becomes tense and uncertain. Gradually, the entire musculoskeletal system is exposed to osteochondrosis, and the intervertebral discs continue to collapse.
Pain syndrome (pain in lumbar osteochondrosis)
Unpleasant sensations and discomfort in the back area are the main symptoms of osteochondrosis. The nature and strength of pain varies depending on the stage of development of the disease.
At first, it is felt only in the lumbar region at the time of increased tension in the joints, muscles and ligaments, that is, when performing physical exertion. It may also be permanent aching. But as osteochondrosis develops, acute pain or backache occurs even when sneezing, coughing.
Palpation, as a rule, allows you to determine the compaction in the muscles. An attack of pain can last for several days, and all this time the patient has to stay in bed to minimize discomfort in the back. Any sudden movements, lifting weights provoke the appearance of discomfort.
Causes of lumbar osteochondrosis
The following main causes of the development of lumbar osteochondrosis are distinguished:
Uneven load on the spine. According to experts, osteochondrosis is characteristic of a person as a biological species, as it is largely due to his lifestyle and upright posture. The need to maintain the position of the body in a certain position requires constant tension of the musculoskeletal system. The optimal load on the spine will be in a standing position. In the supine position, it is minimal, on the side – a little more. But in a sitting position, the load on the lumbar spine increases significantly. The forward tilt of the body creates additional stress on the front edge of the vertebrae and the spinal column. Therefore, it is recommended to periodically change the position of the body, allowing the muscles to relax and shifting the load on the spine, and keep your back straight.
Hypodynamia. A sedentary lifestyle, the use of a car and public transport, spending a lot of time at a computer and TV – all this contributes to the development of problems with the spine, including osteochondrosis. A significant part of the population lacks physical activity. A passive lifestyle leads to the weakening of the musculoskeletal system. In a sitting position, the spine is subjected to maximum load, this causes deformation of the cartilage tissue, and as a result, osteochondrosis of the lumbar region. Therefore, it is so important to periodically get up and perform a set of exercises. When a person spends a significant part of the time in a bent position, the flexor muscles stretch and lose their tone.
Too much physical activity. Increased physical activity, as well as its lack, can also cause osteochondrosis. Back pain is often a concern for athletes who are engaged in weightlifting. This sport requires lifting weights, which creates additional tension for the back muscles and provokes the formation of intervertebral hernias.
Wrong posture. With a curved position of the spine, the load on it is unevenly distributed, and this leads to deformation of the intervertebral discs. Wrong walking has the same effect. Older and older people fall into the risk group, as over time, the intervertebral discs become less elastic, lose their mobility and are more easily damaged.
Skeletal defects and genetic predisposition, injuries and infectious diseases. As a rule, osteochondrosis is caused by congenital problems with the musculoskeletal system. In addition, the cause of the disease can be the natural fragility of the cartilage tissue. Osteochondrosis also develops as a complication after various injuries of the spine, osteomyelitis, and tuberculosis.
Flat feet. In patients suffering from flat feet, the arch of the foot does not perform shock-absorbing functions, as it does in the normal state. Thus, when moving, the intervertebral discs take on the entire load, as a result of which their rapid wear occurs.
Overweight. Extra pounds are a source of additional stress on the heart and musculoskeletal system, including the spine. According to statistics, overweight people are more susceptible to various diseases.
Inflammatory processes in the body. The development of osteochondrosis is facilitated by such factors as hormonal changes, problems with the joints of the spine, for example, rheumatoid arthritis, disruption of the endocrine, digestive and cardiovascular systems.
Образ жизни. Many patients do not pay due attention to their health: they move little, do not get enough sleep, and eat improperly. This leads to increased fatigue, impaired psycho-emotional state, stress. All this makes the body very vulnerable and contributes to the development of lumbar osteochondrosis.
Degrees of osteochondrosis of the lumbar
There are 4 degrees of osteochondrosis of the lumbar:
Cracks appear inside the fibrous ring, which are filled with a substance from the nucleus pulposus, which causes irritation. At this stage, the deformation of the intervertebral discs is weakly expressed and manifests itself in the form of reflex-pain symptoms. The patient may complain of pain in the heart, lower back. In the back area, sudden movements, lifting weights become the cause of discomfort. Depending on the nature, 2 types of pain are distinguished: lumbalgia and lumbago. In the first case, it is stable, and in the second it occurs suddenly;
The destruction of the fibrous ring continues. However, at the same time, there is a reduction in the gap between the vertebrae, pinched nerve endings. At this stage, such a phenomenon as lumbar pseudospondylolisthesis is characteristic. This is the name of the process of displacement of the vertebrae relative to each other, which leads to pinched nerve endings and causes pain. As a result, the spine is characterized by unusual mobility. With osteochondrosis of the 2nd degree, patients complain of pronounced discomfort in the back, in the lumbar region one feels alternately hot and cold. The pain is manifested by attacks, during which a person has goosebumps on the skin and sweating increases;
The fibrous ring is finally torn, and the nucleus pulposus is squeezed out. An intervertebral hernia appears. Extrusion of the nucleus into the region of the spinal canal leads to compression of the vessels and roots of the spinal nerves.
Spinal deformity is in the form of lordosis, kyphosis or scoliosis. In lordosis, the spine is convex forward. Such a violation of its normal position significantly complicates the work of internal organs and their systems. With kyphosis, the upper spine is bent, and there is a feeling of stoop or hunchback in advanced cases. Lateral curvature manifests itself in the form of scoliosis. When a patient suffering from osteochondrosis with such curvature of the spine leans forward, asymmetry becomes noticeable due to the protruding scapula or rib;
The last stage of osteochondrosis is the most dangerous, since the spine is completely deformed, which makes it impossible for full-fledged physical activity. On the x-ray, bone growths become visible. Although pain does not bother the patient for some time, this does not indicate an improvement. 4 degree of osteochondrosis most often ends with disability.
Why is lumbar osteochondrosis dangerous?
Osteochondrosis leads to a weakening of the musculoskeletal system, atrophy. In addition, the disease contributes to problems with various organs in the body. The most common of these are disorders of the genitourinary system. For women, osteochondrosis creates a risk of deformities of the intervertebral discs during pregnancy, when the spine experiences a significant load. Men experience problems with potency. Deformation of the intervertebral discs due to osteochondrosis leads to the appearance of hernias. They require a long and complex treatment, in some cases, surgery is necessary.
With osteochondrosis, blood vessels are squeezed and the intervertebral foramens through which they pass are reduced. As a result, there is a risk of developing compressive-vascular ischemia. It implies additional compression during the movement of the damaged spine and clamping of blood vessels. The phenomenon of “narrow bed” is associated with compression-vascular ischemia. The clamping of the vessel in this case occurs reflexively through the opening of the spinal canal.
Another complication that osteochondrosis can cause is protrusion of the intervertebral discs. In the future, it leads to the development of such a serious disease as an intervertebral hernia. With protrusion, the intervertebral discs protrude beyond the fibrous ring without causing its rupture. This process is accompanied by aching pains that are permanent. Protrusion is evidenced by tingling in the feet, numbness, pain in the feet and fingers, during urination.
As a complication of osteochondrosis, spondylarthrosis is possible. Sometimes it stands out as a special form of the disease. Spondylarthrosis manifests itself in the form of bony spike-like growths. The pain is localized. Unlike unpleasant sensations with such complications of osteochondrosis as hernias, protrusions, it does not spread to the legs, does not cause numbness and tingling. The pain increases with sharp turns and some other movements of the spine.
Patients with osteochondrosis are more susceptible to foot paresis. In this case, they develop back pain, which gradually spreads to the popliteal region, and then causes dysfunction of the foot. She doesn’t rise and fall. While walking, the patient is forced to raise his leg high. In most cases, paresis requires surgery to restore the function of the foot.
Deformation of the intervertebral discs in osteochondrosis causes spondylosis. It implies the appearance of beak-shaped protrusions or spurs on the spine above the protruding intervertebral discs. Such bone outgrowths are a kind of protective mechanism that works in response to changes in cartilage tissue. With osteochondrosis, the spine becomes unstable, so the body tries to correct this by increasing the area of the vertebral body. This is how spondylosis develops.
All complications caused by osteochondrosis are treated with difficulty and significantly complicate the patient’s life, limiting his ability to work and ability to move. Therefore, it is important to start the fight against the disease in time, preventing serious consequences and disability.
Methods of diagnosis
Diagnosis of osteochondrosis involves the use of various methods, primarily palpation of the lumbar.
In the course of it, in the presence of this disease, the following symptoms are detected:
kyphosis, that is, a wedge-shaped deformity of the vertebrae;
scoliosis, which is a body asymmetry or curvature of the spine. With scoliosis, the patient’s ribs or scapula protrude, which should not be in a healthy person;
change in the curvature of the spine – flattening of the lordosis;
pain in the lumbar region;
displacement of one of the buttocks.
Patients usually have difficulty performing active movements with a load on the spine.
The most modern diagnostic methods are:
X-ray of the lumbar. It is performed in direct posterior and lateral projections, which are mutually perpendicular. Based on the picture, the specialist determines the shape, structure and contours of the vertebrae, spinal deformities and bone growths on it. With osteochondrosis, it is noticeable on the x-ray that the intervertebral gap is narrowed, there are salt deposits in the tissues of the disc, marginal growths of the vertebral bodies are observed;
Computed tomography of the lumbar. The use of this method has a lower radiation load on the body compared to radiography. The patient does not experience pain during the examination. As a result of the tomography, it is possible to obtain more informative images than with radiography.
Magnetic resonance imaging of the lumbar spine. MRI, like the other two methods, does not cause discomfort to the patient and does not harm the body. According to the pictures that are created using electromagnetic radiation, it is possible to diagnose not only osteochondrosis, but also many other diseases of the spine.
Treatment of osteochondrosis of the lumbar spine
Treatment of osteochondrosis requires extensive complex therapy, which involves moderate physical activity, the use of medications, massage, physiotherapy, spinal traction, and manual therapy. Surgical intervention is resorted to only in a number of cases.
As a rule, the need for surgery is indicated by cauda equina syndrome, as well as the patient’s loss of control over urination and defecation. An MRI should be done to confirm the diagnosis. Before carrying out the operation, it is recommended to consult with several specialists, as it is often possible to get by with conservative methods of treatment.
Exercise therapy for lumbar osteochondrosis
Therapeutic exercise is one of the most effective ways to get rid of osteochondrosis. It is often compared to massage, which provides a short-lived effect. After all, a massage therapist can stretch the spine, but if the muscles do not support the vertebrae in the desired position, pain and deformities will soon reappear.
Physical therapy for osteochondrosis should be done under the guidance of an instructor. It is important to do the exercises correctly, so it is better to do them in front of a mirror. For best results, workouts should be regular. This allows you to return the spine flexibility, mobility, normalize the metabolism in the body, form a muscular corset.
Gymnastics for osteochondrosis of the lumbar
Gymnastics for osteochondrosis should include only those exercises that do not cause discomfort to the patient. If the implementation of some is accompanied by pain, you should return to them later, when the improvement in the health of the spine becomes noticeable. It is also necessary to prevent too much tension for the muscles, increase the load gradually.
As part of gymnastics with osteochondrosis, you can perform the following exercises:
from a standing position, bend the whole body back and forth, right and left;
get on all fours and take a few steps forward, then return to the starting position, repeat the exercise several times;
lie down on a flat surface and strain your abdominal muscles, pressing your back into the floor;
stretch your arms behind your head and reach for them with your whole body.