Lumbar osteochondrosis: symptoms, treatment, causes, exercise therapy

Osteochondrosis is degenerative-dystrophic disease of the spine, in which the intervertebral disc changes, after which the bodies of adjacent vertebrae, intervertebral joints and ligamentous apparatus are involved in the process.

In each department of the spine( there are only 5 of them), the degenerative process has its own "favorite place" and features of manifestation.

In the lumbar region, changes in the intervertebral discs occur most often, since it is this department that has the maximum load. It is on him that all our incorrect movements, squats, and heavy lifting are affected. The incidence of this disease over time does not tend to decrease.

When striking people over 30 years of age, osteochondrosis leads to a decrease in their ability to work and even to disability if it is not treated on time. Men are more often ill.

The essence of the disease

All the vertebrae, except for the first two cervical and all five coccygeal, have almost the same structure: the body, that is, a whole dense structure of cylindrical shape, and an arc consisting of several processes.

The body is connected to the arc by means of arched bone beams - legs;between them is localized an orifice, called vertebral. Vertebral openings, forming one another, form a vertebral or spinal canal, in which the spinal cord passes.

Spines of the vertebrae, moving in different directions from the arc, form among themselves various inactive joints. And in the holes between those of them that go down or up and to the sides, pass the spinal nerves and vessels.


After 30 years of life, water exchange in the intervertebral disc begins to deteriorate, which gives rise to the development of the degenerative process. As a result, its fibrous bulk becomes thinner and brittle. Pulpoid nucleus is forced to expand its boundaries, and it makes a "move" in the direction where the fibrous part renders it the least resistance - towards the spinal canal. The spinal cord or the nerves leaving it turn out to be compressed, their edema develops. Therefore, the pain arises, and the functions of the organs to which the commands from these sections went were violated.

As a result of changes in the structure of the intervertebral disc, the vertebral substance undergoes an increased pressure from all of the above-lying divisions. This pressure commands the bone cells to accelerate their division, resulting in local bone "spines" - osteophytes. The intervertebral disc, like any cartilage, can not be regenerated. The functions of organs from squeezing such "spines" are broken even more.

Causes of lumbar osteochondrosis

There are several theories trying to explain the origin of lumbar spine osteochondrosis:

1. 1) Osteochondrosis develops due to premature development of aging processes in discs.
   
2. 2) The cause of the pathology is in constant tension or, conversely, the weakness of the muscles supporting the spine.
   
3. 3) Incorrect load on the spine, when only a certain part of the joint between the bodies of two adjacent vertebrae is subjected to overloading.
   
4. 4) Hereditary predisposition of the cartilage of the disc to the development of degenerative processes in it.
   
5. 5) Damage of the disk with its own antibodies, as a result of which its food will be disturbed.

Each of these theories to some extent explains the cause of the disease. This process is started under the influence of such factors:

• back injury;
  
• excess weight;
  
• intensive physical activity;
  
• diseases and conditions in which the metabolism in the body is disturbed;
  
• constant wearing of uncomfortable shoes;
  
• incorrect posture;
  
• spine defects( scoliosis, kyphosis);
  
• flat feet;
  
• tuberculosis of the spine;
  
• osteomyelitis;
  
• Bechterew's disease;
  
• rheumatoid arthritis;
  
• diabetes mellitus;
  
• hormonal disorders;
  
• frequent hypothermia.

See also, symptoms of cervical osteochondrosis.

Symptoms of lumbar osteochondrosis

In women and men, the first symptom of lumbar osteochondrosis is lower back pain. Initially, it appears only with considerable physical exertion, disappears when resting, later worries even with a fairly long walk.

Pain can be permanent, aching, or can be shooting. She gives in the buttock, leg, inner thighs.

With a reduction in the distance between the vertebrae and further destruction of the intervertebral disc, unusual sensations appear in the lumbar region - cold or, conversely, heat. Pain syndrome in the back and leg becomes strong, there is a sense of "goose bumps".

If the process progresses, the spine begins to rotate around its axis with the formation of lordosis and scoliosis;The pulpous nucleus is squeezed out of the way. This is manifested by the symptoms of squeezing the roots of the spinal nerves and vessels.

The development of lumbar osteochondrosis, and its symptoms will differ depending on which root of which nerve is sandwiched between the vertebrae. The lower the degenerate process is localized, the closer to the foot the site will be located, in which will be:

• reduced the volume of muscle movements;
  
• decreased tendon reflexes;
  
• feel "creepy", "tingling";
  
• to reduce pain, temperature and vibration sensitivity of tissues.

If the roots of the cauda equina are involved( this is the continuation of the spinal cord in the form of a bundle of nerve roots), this is manifested by the following symptoms:

• unbearable pain in the back;
  
• loss of sensitivity or pain in one or both lower limbs;
  
• loss of sensitivity on the inside of the thighs;
  
• urinary incontinence or retention;
  
• constipation;
  
• menstrual dysfunction in women;
  
• decreased libido;
  
• lack of sensitivity in the area of ​​the sphincter of the rectum;

In the last stage of osteochondrosis of the lumbar region, pain constantly worries a person. He has paralysis of one or two lower limbs, leg muscles atrophy. Violated sexual functions, there are incontinence( or delay) of urine and feces.

Complications of

Osteochondrosis of the lumbar spine is complicated by such pathologies and conditions:

• intervertebral hernia( see hernia of the lumbar spine).
  
• compression of the spinal cord.
  
• complete obstruction of the spinal canal.
  
• impotence.
  
• paralysis of the lower extremities.
  
• of renal colic.

Diagnosis of lumbar spine osteochondrosis

A preliminary diagnosis of a neurologist or vertebrologist can be made already according to the complaints presented, and also according to the examination:

• scoliosis, hypo- or hyperlordosis;
  
• tenderness when pressing on certain points;
  
• decrease in the volume of movements in the foot;
  
• asymmetry of the buttocks;
  
• curvature of the rhombus Michaelis.

The final diagnosis, as well as the degree of progression of the degenerative process and possible complications, will help to establish such studies:

1. 1) X-ray study. This is the least accurate diagnosis, which allows only to establish a diagnosis. Judging the patency of the spinal canal and the degree of damage to the roots can only be indirectly.
   
2. 2) Computed tomography of the lumbar region. This and subsequent methods not only help in diagnosing, but also visualize the degree of spinal cord injury.
   
3. 3) Magnetic resonance imaging of this department.

Read also how to treat chest osteochondrosis.

Treatment of lumbar osteochondrosis

Lumbar osteochondrosis requires a competent and integrated approach to treatment, which will include conservative and operational tactics.

Drug therapy - treatment of the disease necessarily includes the patient receiving such groups of medicines:

1. 1) Anti-inflammatory drugs. In the initial stages of the disease, you can apply them only in the form of ointments: Voltaren Emulgel, Diklak. Later, they switch to taking painkillers: Diclofenac, Indomethacin, Nurofen, Movalis. They can not be taken if a person suffers from a peptic ulcer or gastritis. In this case, preparations of "Rofika", "Celebrex" or others from the same group will do.
   
2. 2) Muscle relaxants are drugs that help relax those muscles that have spasmed, trying to straighten the spine. This is "Midokalm", "Sirdalud".
   
3. 3) Chondroprotectors. These drugs( Dona, Structum, Teraflex, Mukosat and others) can be used only if the intervertebral disc is still present, that is, there is a cartilaginous layer between the vertebral bodies. The effect of these medications is based on the restoration of the structures of the disc, if a person takes them long enough - about six months, with repeated courses.
   
4. 4) Group B vitamins: "Milgamma", "Neurorubin".

Manual therapy and massage

Very effective therapies that help to relax the tense muscles and tone the paretic. Manual therapy creates the opportunity to give the spine the right position.

But this "tool" should be in the hands of a professional, and help - be provided by the results of tomographic and radiographic images. Methods are applied in the subacute stage of the disease.

Physiotherapeutic methods

For osteochondrosis apply:

• amplipulse;
  
• UHF;
  
• magnetotherapy using a high frequency field.

These procedures have such effects: anesthetic, stimulating, vasodilating, improving blood flow in the affected segment.

LFK and other methods

Without performing special exercises selected by a doctor, treatment of osteochondrosis of the lumbar spine is ineffective( see exercises for osteochondrosis).The complex is not only selected taking into account the process in the spine, but also on the basis of a stage - acute, subacute or restorative - osteochondrosis.

Additional treatment methods are also applied:

• acupuncture;
  
• hirudotherapy;
  
• myostimulation;
  
• spinal traction.

Surgical treatment

The operation is indicated in the case of:

• caudal syndrome;
  
• hernia sequestration;
  
• painful radicular syndrome, not durable with NSAIDs.

At the moment, neurosurgeons are trying to resort to a mini-invasive operation - microdiscectomy, which is performed with the help of microsurgical instruments. Minimally invasive disc nucleoplasty can also be performed.

See also how to treat osteochondrosis at home.

Prevention of lumbar osteochondrosis

To avoid osteochondrosis in the lumbar region, it is necessary to observe such rules:

• did not sit for a long time;
  
• try to periodically rest lying on his back( ideally - sleep on his back);
  
• with cervical spine;
  
• Do not smoke or drink alcoholic beverages.

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