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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 a deformation of the cartilage 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 their elasticity and begin to dry out.

As a result, patients develop severe pain in the lumbar region.

What is it?

When degenerative dystrophic changes appear in the tissues of the vertebrae, they begin to gradually collapse. If mainly the vertebrae located in the lumbar region are affected, osteochondrosis of the lumbar spine is diagnosed.

Clinical presentation

In osteochondrosis, the cartilage tissue of the vertebrae begins to lose moisture, the elasticity of the intervertebral discs deteriorates. Over time, the height between the vertebrae decreases. Under the increased load, the fibrosus ring begins to crack, the intervertebral disc protrudes.This leads to 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 on the bone tissue of the vertebrae, which press on the 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 exertion. Patients talk about the appearance of dull back pain, sometimes they radiate to the buttocks.
  2. The distance between the vertebrae gradually decreases, and the fibrosus ring begins to collapse. Intervertebral discs are compressed, exceed physiological limits, there is pressure on the nerve roots. Patients complain of tangible pain, which when walking is transmitted to the buttocks, thighs and legs. In addition to pain, a burning sensation, cold is possible.
  3. The fibrous rings are destroyed and on examination, patients reveal herniated discs. Pain is constantly disturbing, regardless of the load.
  4. The bony growths of the vertebrae are visible. The cartilage atrophies, it becomes difficult for the patient to move. As a result, the lumbar spine loses its mobility and flexibility, and the patient becomes disabled.
They also classify osteochondrosis by type of disease course:
  • relapse;
    • chronic
  • ;
  • relapses chronically.
  • regressed (with exacerbations, the clinical manifestations of the disease decrease);
  • progressive (progressive);
  • not progressive.

Experts distinguish the following osteochondrosis period:

  • 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.

CIM 10 code

According to the International Classification of Diseases, spinal osteochondrosis was assigned the code M42. Separately, there is juvenile (M42. 0), adult (M42. 1) and unspecified (M42. 9) osteochondrosis.

Prevalence and importance

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

Most often, people who have passed the 30-year marksuffer from osteochondrosis of the lumbar spine. Although it can be found in younger patients. Almost 80% of patients who see the doctor for pain in the lumbar region are diagnosed with osteochondrosis.

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

Without adequate treatment, the disease progresses. In neglected forms, it leads to the patient's disability.

Risk factors and causes

Often representatives of these professions are faced with osteochondrosis: programmers, office workers, builders, loaders, servers and driver.

Long stay in an awkward position is a risk factor for developing lumbar osteochondrosis

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

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

Reasons for the development of osteochondrosis of the lumbar spine include:

  • natural aging process of the body;
  • metabolic problems;
  • back injuries;
  • back problems;
  • flat feet;
  • intense physical activity, such as weight lifting;
  • problems with the joints of the spine (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 between the vertebraeleads to deterioration of the fibrosus ring and the appearance of a hernia. Patients begin to complain of severe pain in the lumbar region, which radiates to the gluteal muscles, thighs and lower legs. But this is not the only possible complication of osteochondrosis.

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

With osteochondrosis, sciatica may develop(inflammation of the sciatic nerve). The disease causes severe pain, numbness in the lower back and legs. The patients begin to walk, leaning to one side. This causes further curvature of the spine and further destruction of the intervertebral discs.

Osteochondrosis causes instability of the vertebrae. The lumbar region, under the influence of the weight of the body, begins to move from the sacrum. In women, such instability provokes the appearance of problems with the internal organs (the uterus, ovaries, appendages suffer), in men - with potency.

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

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

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

Symptoms

Osteochondrosis does not appear immediately. In the early stages, the patient has no pain or discomfort. Usually, complaints appear when the disease reaches stage 2.

The main symptoms of lumbar osteochondrosis are:

  • lower back pain that worsens as the disease progresses;
  • reduced mobility: problems appear when trying to bend over, turn around, sensations when changing body position are described by patients as "electric shocks", while many of them experience painin the leg;
  • change in the sensitivity of the extremities, which appeared against the background of damage to the nerve roots, in the affected area there is a burning sensation, numbness, crawling crawls, tingling;
  • muscle weakness, lack of tendon reflexes;
  • local temperature drop;
  • increased sweating;
  • pallor, dry skin in the problem area;
  • urination disturbances, sexual dysfunction (in severe osteochondrosis).

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

Which doctor treats?

If you have back pain, you shouldsee an orthopedist and neurologist. The examination assesses the neurological condition of the patient, checks how the spine performs its functions. Doctors also assess the condition of the back and buttock muscles.

For experienced specialists, one examination is sufficient to establish a preliminary diagnosis. But to confirm this, the patient is sent to hardware diagnostics.

Diagnostic methods

The simplest and most accessible method of detecting osteochondrosis isX-ray. But to get a more accurate picture, a computer or magnetic resonance imaging is prescribed.

The

MRIallows you to examine the condition of the spine as precisely as possible. Indeed, during the procedure, layer by layer images of the problem area are taken.

Processing

Physiotherapy for the treatment of lumbar osteochondrosis

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

Your doctor may prescribe:

  • drug therapy, nonsteroidal anti-inflammatory drugs, hormonal drugs, analgesics are selected;
  • drug blockade, analgesics, hormonal drugs are injected into the affected area or into the muscles around the problem vertebra, which almost instantly relieves inflammation and removes pain;
  • manual therapy, massage, physiotherapy, is recommended after the cessation of the acute stage of the disease, with the help of physiotherapy, you can improve the effectiveness of drug therapy;
  • medical gymnastics;
  • acupuncture.

Operation required in advanced cases. Surgical intervention is prescribed in situations where conservative treatment does not bring the expected results.

Conclusion

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

  • You may suspect the development of osteochondrosis by the appearance of lower back pain. With the progression of the disease, the pain increases significantly, the lower back loses mobility.
  • Depending on the degree of destruction of the intervertebral discs, there are 4 stages of the disease.
  • Most often this diagnosis is made to people after 30 years. Almost 80% of patients who see the doctor for back pain are diagnosed with osteochondrosis.
  • People who lead an inactive lifestyle are susceptible to osteochondrosis, are in an unnatural position for a long time, and experience frequent physical overload.
  • The main symptoms of osteochondrosis are pain and reduced mobility of the lower back.
  • Due to the destruction of the intervertebral discs of the lumbar spine, patients develop leg problems.
  • If left untreated, the pain increases,sciatica, spinal instability, compression myelopathy may developIn advanced cases, it paralyzes the lower limbs.
  • In case of painit is necessary to consult a neurologist and an orthopedist. The patient is sent for an x-ray, computed tomography or magnetic resonance imaging.
  • Depending on the condition,are prescribed medications, blockages, massage, manual therapy, physiotherapy, exercise therapy, or surgery.