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Lumbar osteochondrosis

Osteochondrosis of the lumbar spine

Lumbar osteochondrosisis ​​one of the most common diseases of the spine.

It is characterized by the deformation of the cartilaginous tissue of the vertebrae.

The spine remains flexible and mobile as long as the vertebrae are healthy.

If the condition worsens, the intervertebral discs lose elasticity and begin to dry out.

As a result, patients develop severe pain in the lower back.

What is it?

When dystrophic-degenerative changes appear in the tissues of the vertebrae, they gradually start to collapse. If the vertebrae located in the lumbar region suffer mainly, then osteochondrosis of the lumbar spine is diagnosed.

Clinical presentation

In osteochondrosis, the cartilage tissue in the vertebrae begins to lose moisture, the elasticity of the intervertebral discs deteriorates. Over time, the height between the vertebrae decreases. Under increasing load, the fibrous ring begins to crack, the intervertebral disc protrudes.This leads to the pinching of nerve endings and the appearance of pain.

In the absence of adequate treatment, osteochondrosis progresses. Intervertebral discs harden, their damping properties deteriorate. Growths form in the bone tissue of the vertebrae, which press on nerve endings. Because of this, patients develop constant pain.

Degrees and classification

Experts distinguish 4 degrees of spinal osteochondrosis:

  1. The process of destruction of the intervertebral discs begins, the symptoms of the disease are mild, a burning sensation, tingling, pain appears only after physical effort. Patients talk about the appearance of uncomfortable back pain, sometimes radiating to the buttocks.
  2. The distance between the vertebrae gradually decreases and the fibrous ring begins to collapse. Intervertebral discs are compressed, exceed physiological limits, there is pressure on nerve roots. Patients complain of tangible pain, which in the process of walking is given to the buttocks, thighs, legs. In addition to pain, a burning sensation, cold is possible.
  3. Fibrous rings are destroyed, during the examination, intervertebral hernias are revealed in the patients. The pain constantly bothers you, regardless of the load.
  4. Bone outgrowths of the vertebrae are visible. Cartilage atrophies, it becomes difficult for the patient to move. As a result, the lumbar spine loses mobility and flexibility, and the patient is disabled.
recurring
They classify osteochondrosis also by the type of disease course:
  • ;
    • chronic
  • ;
  • with chronic relapse.
  • regressed (with exacerbations, the clinical manifestations of the disease decrease);
  • progressive (progressive);
  • not progressive.

Experts distinguish this period of osteochondrosis:

  • debut;
  • aggravation;
  • remission;
  • stabilization.

Treatment is selected depending on the stage of the disease, the nature of the deformity and the severity of the symptoms of the disease.

ICD code 10

According to the international classification of diseases, spinal osteochondrosis received the code M42. Separately, there are juvenile (M42. 0), adult (M42. 1) and unspecified (M42. 9) osteochondrosis.

Prevalence and significance

The lower back is more prone to the development of osteochondrosis than other parts of the spine. This is due to the increased load in this area, as it must support body weight. With a weak muscle corset, the condition of the intervertebral discs begins to deteriorate rapidly, they are destroyed.

Most often, people over the age of 30suffer from osteochondrosis of the lumbar spine. Although it can be found in younger patients. Almost 80% of patients who come to the doctor with complaints of pain in the lower back are diagnosed with osteochondrosis.

Examination of patients over 40 years old revealed that most of them have characteristic changes in the intervertebral discs. But, in the absence of clinical manifestations, a person is not considered sick.

In the absence of adequate therapy, the disease progresses. In neglected forms, it leads to the patient's disability.

Risk factors and causes

Often, representatives of such professions encounter osteochondrosis: programmers, office workers, builders, porters, waiters and a driver.

Long stay in an uncomfortable position is a risk factor for the development of lumbar osteochondrosis

Risk factors, in the presence of which the likelihood of developing osteochondrosis increases, include:

  • being overweight;
  • unhealthy diet;
  • problems with posture;
  • genetic predisposition;
  • lack of sleep;
  • frequent stress;
  • constant hypothermia;
  • needs to be in an uncomfortable position for a long time;
  • low physical activity.

The reasons for the development of osteochondrosis of the lumbar spine include:

  • natural body aging processes;
  • metabolic problems;
  • back injuries;
  • back problems;
  • flat feet;
  • intense physical activity, for example, weight lifting;
  • problems in the spine joints (rheumatoid arthritis);
  • endocrine diseases;
  • problems with the digestive and cardiovascular system.

Some experts believe that the propensity to develop osteochondrosis is transmitted at the genetic level.

Consequences

A change in the cartilage tissue located between thevertebrae leads to a deterioration of the fibrous ring and the appearance of a hernia. Patients begin to complain of severe pain in the lower back, which radiates to the gluteal muscles, thighs and legs. But this is not the only possible complication of osteochondrosis.

Prolonged irritation of the spinal nerve leads to inflammation.Patients develop lumbar sciatica.

In osteochondrosis,sciatica(inflammation of the sciatic nerve) can develop. The disease leads to severe pain, numbness in the lower back and legs. Patients start walking, leaning to one side. This causes additional curvature of the spine and further destruction of the intervertebral discs.

Osteochondrosis causes instability of the vertebrae. The lower back, under the influence of the body's weight, begins to move from the sacrum. In women, this instability causes problems with internal organs (the uterus, the ovaries, the appendages suffer); in men - with the potency.

When the intervertebral discs are destroyed, the blood supply to the spinal cord is interrupted, displacement of the vertebrae leads to compression myelopathy.

Cauda equina syndrome is considered the most dangerous complication. It consists of the fact that the nerve roots are affected. In severe cases, osteochondrosis causes paresis of the lower extremities or paralysis of both legs.

It is possible to prevent the development of negative consequences if, when the first symptoms appear, consult the doctor and do not ignore the need for treatment.

Symptoms

Osteochondrosis does not appear immediately. In the early stages, the patient does not experience pain or discomfort. Complaints usually appear when the disease progresses to stage 2.

The main symptoms of lumbar osteochondrosis include:

  • low back pain that worsens with disease progression;
  • impaired mobility: problems appear when trying to bend, turn, sensations when changing the position of the body are described by patients as "electric shock", the pain in many of them radiates to the leg;
  • alteration in the sensitivity of the extremities, which arose in the context of lesions in the nerve roots, in the affected area there is a burning sensation, numbness, crawling chills, tingling;
  • muscle weakness, lack of tendon reflexes;
  • drop in local temperature;
  • increased sweating;
  • pallor, dry skin in the problem area;
  • urinary disorders, sexual dysfunction (with severe osteochondrosis).

Some patients have a spasm of the arteries in their legs. But the symptoms are expressed only in the acute form of osteochondrosis. An exacerbation can start suddenly with hypothermia, awkward movements or after intense physical activity.

Which doctor is treating?

If you have back pain, you shouldsee an orthopedist and neurologist. The exam assesses the patient's neurological condition, verifies how the spine performs its functions. Doctors also assess the condition of the back and gluteal muscles.

For experienced specialists, an examination is sufficient to establish a preliminary diagnosis. But to confirm, the patient is referred for hardware diagnosis.

Diagnostic methods

The simplest and most accessible method for detecting osteochondrosis isradiography. But to get a more accurate picture, a computer or MRI image is prescribed.

The

MRImakes it possible to examine the condition of the spine as accurately as possible. In fact, during the procedure, photos are taken layer by layer of the problem area.

Treatment

Physiotherapy for the treatment of lumbar osteochondrosis

Therapy tactics are selected by the doctor depending on the patient's condition, stage of osteochondrosis and clinical manifestations of the disease.

The doctor can prescribe:

  • drug therapy, non-steroidal anti-inflammatory drugs, hormonal drugs, analgesics are selected;
  • blocking drugs, painkillers, hormonal drugs are injected into the affected area or into the muscles located around the problematic vertebra, which almost instantly relieve inflammation and remove pain;
  • manual therapy, massage, physiotherapy, is recommended after the interruption of the acute stage of the disease, with the help of physiotherapy, you can increase the effectiveness of drug treatment;
  • medical gymnastics;
  • acupuncture.

Operation required in advanced cases. Surgical intervention is indicated in those situations in which conservative treatment does not bring the expected results.

Conclusion

With the progression ofdystrophic-degenerative changes in the lumbar spine cartilage tissues, osteochondrosis is diagnosed. In advanced forms, this disease can lead not only to the onset of severe constant pain, but also to cause paresis, paralysis of the lower limbs.

  • You may suspect the development of osteochondrosis by the appearance of low back pain. As the disease progresses, the pain increases significantly, the lower back loses mobility.
  • Depending on the degree of destruction of theintervertebral discs, there are 4 stages of the disease.
  • Most often, this diagnosis is given to people after 30 years. Almost 80% of patients who go to the doctor because of back pain are diagnosed with osteochondrosis.
  • These people who lead an inactive lifestyle are susceptible to osteochondrosis, stay in an unnatural position for a long time, experience frequent physical overload.
  • The main symptoms of osteochondrosis are pain and limited mobility in the lower back.
  • Due to the destruction of the intervertebral discs in the lumbar spine, patients develop leg problems.
  • If left untreated, there may be increased pain,sciatica, spinal instability, compression myelopathy. In advanced cases, it paralyzes the lower limbs.
  • In case of painit is necessary to consult a neurologist and orthopedist. The patient is referred for radiography, computed tomography or magnetic resonance imaging.
  • Depending on the condition,is ​​prescribed medication, blocks, massage, manual therapy, physiotherapy, physical therapy exercises or surgery.