What is osteochondrosis of the lumbar spine?

4 December 2024

Osteochondrosis of the lumbar region is a pathology of the musculoskeletal system, accompanied by degenerative-dystrophic changes in bone tissue and impaired function of the lower five vertebrae (from 20 to 24). This disease causes discomfort to the patient and is characterized by certain symptoms - pain, stiffness of movement. Osteochondrosis of the lower back occurs in waves, with periods of exacerbation and remission. According to statistics, this form is one of the most common. Pathology left unattended often leads to irreversible changes and a significant deterioration in the quality of life. However, with an efficient integrated approach, osteochondrosis can be treated successfully.

The main cause of pathology

There is no exact data on why degenerative-dystrophic changes in the spinal column are triggered. It is assumed that the initial mechanism for the development of pathology is premature age-related changes in the joints. They can be determined genetically - transmitted through inheritance, but often they initially manifest under the influence of unfavorable factors.

The main one among them is considered to be the incorrect distribution of the load on the spine. Osteochondrosis of the lumbosacral spine can develop with:

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

Those at risk for the development of osteochondrosis include the elderly who are characterized by natural destructive changes in cartilage and bone tissue, professional athletes who train daily and intensively, pregnant women, whose center of gravity changes as the fetus grows and loads on the lower part. back increased significantly, office workers, had to spend a lot of time in a sitting position.

In addition to external risk factors, doctors also call a group of internal ones. These include:

previous injury to the musculoskeletal system;
curvature of the spine;
flat feet;
congenital dislocation or subluxation of the hip joint;
autoimmune disorders;
inflammation of joint tissue;
pathology of the circulatory system;
endocrine diseases;
obesity.

Osteochondrosis of the lower back can also be provoked by prolonged intoxication and dehydration, bad habits, lack of calcium, and any mechanical impact on the lower back - bruises, blows, falls.

Osteochondrosis of the lumbar spine: symptoms

Pathology affects not only the bone tissue itself, but also the entire movement segment of the spine - vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Osteochondrosis of the lumbar spine develops, the symptoms of which become apparent with significant damage, gradually and slowly. At the initial stage it is a moderate discomfort during exercise, at a later stage it is an unbearable acute pain. Clinical signs are expressed in the acute stage. During the period of remission, they fade, and in the early stages this happens even without treatment.

Osteochondrosis of the lumbar spine - symptoms:

pain in the affected area of the spine;
radiating pain up to the shoulder blade area or down to the pelvis and hip joints;
constant feeling of tension in the lower back;
difficulty bending and turning;
lazy;
lameness;
muscle weakness or, conversely, increased tone;
tingling sensation.

Not all of the symptoms described are always present at once. Pain may be associated with limited movement, but not muscle weakness or numbness. Any of the signs discussed above will be a reason to consult a doctor.

Disease stage

The intensity of the symptoms that accompany osteochondrosis of the lumbosacral spine directly depends on the degree of development of the pathology. There are four of them in total.

First stage. The first structural and functional changes begin. The intervertebral disc is dry and may crack. Symptoms at this stage are minor. Many patients think they are tired after a long day at work, wearing uncomfortable shoes or exercising. The main symptoms of early osteochondrosis are mild discomfort in the lower back, which increases with bending and turning. Mild pain is possible, which will subside on its own after rest.
Second stage. The height of the intervertebral disc decreases, the bone structure becomes closer. This creates a new round of symptoms - stiffness when moving and pain. The pain becomes prolonged and intense, and may radiate to the pelvis and legs.
Third stage. At this stage, the vertebrae become deformed. Protrusions are formed - the intervertebral disc bulges into the area of the spinal canal, but the fibrous ring remains intact. The main symptoms are severe pain, disturbing even at rest, decreased sensitivity, throbbing and clicking when moving, tingling and numbness in the lower back.
Fourth stage. Pathological changes continue to develop. Vertebral function is lost. Form of hernia. Osteophytes—bone growths—are formed. Blood vessels may be pinched and nerve fibers pinched. Against the background of impaired blood circulation, the function of the pelvic organs is disturbed. In men, the risk of erectile dysfunction increases, in women, disturbances in the menstrual cycle are observed. Advanced osteochondrosis is manifested by sharp lumbago in the lower back, lameness, impaired mobility up to complete immobility, and increased temperature.

If you are concerned about lumbar osteochondrosis, the treatment will directly depend on the stage at which the disease is diagnosed. In the early stages, the doctor has more methods and techniques of rehabilitation in his arsenal. Detection of degenerative-dystrophic changes at an early stage makes it possible to treat the pathology conservatively, without resorting to surgical intervention.

Pathological form

The division into forms is based on the characteristics of the pain syndrome that always accompanies osteochondrosis of the lumbar sacral spine. There are three in total:

Lumbago. This is an acute shooting pain that makes it impossible to move. The causes of pain can be pinched nerves or muscle spasms.
Lumbodynia. This is a painful long-term pain. It is a characteristic stage of the formation of protrusions and hernias. Also, discomfort may be associated with sprained ligaments.
Sciatica. This is a severe pain that radiates to the pelvic area. The patient complains of pain when walking, sitting, or changing body position.

Two other forms of pathology are distinguished depending on the accompanying symptoms. Patients may be diagnosed with:

Radiculopathy. Accompanied by compression of the nerve endings due to deformation of the vertebrae. With this form of the disease, sensitivity decreases and the affected area becomes numb. Pain and tingling are expressed. Possible decrease in muscle tone, impaired reflexes, tingling in the legs.
Discogenic lumbar osteochondrosis. This is a serious condition where the patient is limited in movement. His lower back and limbs were numb. Other symptoms are general weakness, fever, involuntary urination, and if the disease is prolonged, weight loss.

The danger of spinal disease

If left untreated, osteochondrosis is fraught not only with unbearable pain and stiffness of movement, but also with several pathologies that can develop against its background. The most common complications:

intervertebral hernia;
inflammation of the sciatic nerve;
radiculitis;
paresis.

To avoid concomitant pathology, it is necessary to start treating osteochondrosis immediately from the moment of detection. With an efficient therapeutic approach, it is possible to stop or significantly slow down the destruction of bone and cartilage tissue.

Methods for diagnosing pathology

Osteochondrosis of the lumbar sacral spine must be distinguished from other pathologies of the musculoskeletal system, which can occur with similar symptoms. The main stage is a consultation with a neurologist, orthopedist or surgeon. The doctor explains the complaint, collects an anamnesis, conducts a physical examination, pays attention to the characteristics of the patient's posture and posture, the nature of his work activities, bad habits, and concomitant diseases.

For the most accurate diagnosis, instrumental techniques are used:

MRI;
radiography;
myelography with contrast agent;
multislice CT.

Each diagnostic procedure allows the doctor to assess the state of the lumbar and sacral spine at the current time. The image clearly shows structural changes in the vertebrae, indicating the stage of osteochondrosis. Based on the data obtained, the specialist makes a decision on tactics for further management of the patient.

Laboratory diagnosis is not essential, however, studies may be recommended if indicated. In particular, if lumbar osteochondrosis is diagnosed, treatment may be prescribed based on the results of blood tests. They are necessary to explain the intensity of the inflammatory process in the muscle fibers adjacent to 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 level and extent of tissue damage is determined. Modern medicine offers several effective conservative methods. If its use does not lead to the expected results, the doctor uses surgery.

Lumbar osteochondrosis: treatment with physiotherapy methods

All physiotherapeutic techniques are good because they affect the sacral and lumbar spine as a whole. This approach allows you to overcome pain, reduce inflammation, and restore normal blood circulation.

When osteochondrosis of the lumbar spine develops, treatment should be comprehensive. Patients with prescribed complaints:

electrophoresis - exposure of the problem area to continuous electrical impulses with the possibility of using drugs for external use;
diadynamic therapy - a variant of electrotherapy using pulsed current;
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 physiotherapeutic treatment can only be seen after the course of the procedure, the duration of which is selected individually for each patient. The second is physiotherapy as a functional independent method for early stage osteochondrosis. For large-scale lesions, it is recommended as an additional technique in addition to medical and surgical treatment.

Lumbar osteochondrosis: treatment with drugs

Pharmacotherapy for lesions of the lumbar and sacral spine is aimed at relieving acute pain and suppressing the inflammatory process. This method is relevant in the acute stage, when symptoms interfere with full life.

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

NSAIDs (systemic and local) to suppress inflammation in the vertebrae and adjacent tissues;
muscle relaxant to relieve muscle spasms;
angioprotectors to improve blood circulation;
chondroprotectors to protect intervertebral disc cartilage tissue from destruction;
B vitamins to improve nerve conduction;
analgesic for sharp shooting pains that limit movement.

Exercise therapy as a method of treating pathologies of the sacral and lumbar regions

Intense training for osteochondrosis is strictly prohibited, but you should not completely give up physical activity. On the other hand, strength training and moderate duration help to restore blood circulation and reduce pain.

How to treat osteochondrosis of the lumbar spine with exercise therapy:

Exercise with an instructor. The trainer will show you which exercises are allowed in certain situations and make sure they are done correctly. Even the smallest flaws in technology can significantly reduce the effectiveness of training or cause harm.
Prepare thoroughly for the lesson. Before exercising, it is recommended to warm up the muscles - you can gently massage the lower back and sacrum.
Dose the load strictly. The lower back is a vulnerable area. To avoid overdoing it, you need to monitor the class duration. Their optimal duration is no more than 20 minutes.
Increase exercise intensity gradually. For beginners without experience, simple exercises and short programs are suitable. For those who have been doing exercise therapy for some time, you can move on to more complex options.
Remember to be familiar. A single exercise will not bring significant improvement. Pain in the lumbar and sacral spine is reduced if the patient performs exercise therapy regularly - optimally twice a week.
Consider contraindications. Physical therapy has proven itself to be a safe method to help with osteochondrosis, but there are limitations. You should stop exercising if you feel unwell: fever, weakness, or an increase in temperature.

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

In the acute period. Only smooth and slow movements are allowed. If the pain increases during exercise, you need to stop and give your joints a rest.
In the subacute period. Pain syndrome decreases, mobility is restored, so you can slightly increase the intensity of training and increase its duration. But, to avoid deterioration, you need to carefully monitor your well-being.
In forgiveness. We allow a full range of exercises for lumbar spine pathology, but it is important to remember that too much energy is fraught with exacerbation of new diseases.

If lumbar osteochondrosis is diagnosed with mild or moderate severity, treatment with physical education can also take place at home. After the exercise technique has been perfected under the supervision of the instructor, it is not forbidden to repeat the exercise at home. For training you need a gymnastic mat, rollers and balls.

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 also make activities more fun and interactive. For example, the neuromuscular recovery system turns recovery 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 even the slightest progress in 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 someone's success also motivates the patient to work harder and not give up.

Manual therapy

Good results can be achieved if you add exercise therapy and medication for lumbar pathology with manual therapy. The method enables:

eliminate hypertonicity of muscle fibers;
relieves pain;
restore blood supply in the lumbar and sacrum areas;
improve the course of metabolic processes.

Manual therapy is an effective way to properly redistribute the load on the spine and protect yourself from further damaging changes. The good thing about 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 tecartherapy. Electromagnetic waves penetrate deep bone tissue and allow you to relieve pain attacks and restore mobility quickly.

Surgical method

Osteochondrosis of the lumbar spine, its treatment with drugs, physiotherapy and exercise therapy is not always effective, significantly complicating the patient's life. In some cases, only surgical intervention can be used to eliminate pain and restore back mobility. Modern methods and technological equipment make it possible to perform minimally invasive operations with a shortened recovery period.

For osteochondrosis, the following intervention methods are relevant:

endoscopic isolation of intervertebral hernia - using microsurgical instruments and a built-in camera;
transfacet removal of intervertebral hernia - using a neurosurgical tube dilator;
laminectomy - surgical removal of pathologically changed bone processes;
microdiscectomy - removal of the hernial protrusion.

Direct indications for surgical intervention are recurrent hernias, 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 using conservative methods.

Disease prevention

Symptoms of osteochondrosis cause difficulties, and the treatment of pathology can take a long time. It is more effective to protect the exposed lumbar region from fatigue first. For preventive purposes it is recommended:

Organize your workplace properly during office work. The back of the chair should support the lower back, and the table should be appropriate in height.
Avoid uncomfortable shoes. The optimal heel height for women is up to 5 cm. It is also advisable to exclude flat soles, as they contribute to the deformation of the feet and flat feet - one of the factors.
risk of osteochondrosis.
Exercising. Lifting heavy objects should be avoided. Swimming, walking, and cardio exercises are useful if there are no contraindications.
Eat a balanced diet. The diet must contain foods that are sources of calcium, phosphorus and B vitamins These are fish, dairy products, leafy vegetables, and grains. These substances are necessary to strengthen all elements of the joints and support the nervous system.
Make sure you get enough sleep. It is better to sleep on an orthopedic mattress with medium hardness. It will provide an anatomically correct posture where the body rests from daily stress.
Controlling weight. Obesity is one of the provoking factors. If the body weight is normal, the load on the spine will be distributed adequately, and the risk of circulatory disorders will be minimized.

The prognosis for patients with osteochondrosis directly depends on the degree of damage to the vertebrae. That is why timely diagnosis is so important. If you are worried about lower back pain, and the image reveals a destructive process at an early stage, you need to 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 measure of help in any form and at any stage.