Lumbar Osteochondrosis: Symptoms and Treatment

Lumbar osteochondrosis is a common disease that reduces a person's quality of life and is one of the causes of disability.

The disease is more common in people over the age of 40 and is characterized by gradual progression, thus requiring adequate conservative or surgical treatment.

development mechanism

The main mechanism of osteochondrosis is the violation of nutrition of the cartilage tissue of the spinal structure.

The disease includes several stages of onset:

• Cartilage tissue dystrophy due to malnutrition is a major trigger of pathology.
• Degeneration (damage and destruction) of spinal cartilage (intervertebral discs, vertebral process articular surfaces).
• An inflammatory reaction with tissue swelling, blood stagnation, and pain.
• Changes in the anatomy of the lumbar spine (flattening of the discs, loss of height), resulting in a reduction in the diameter of the holes between the vertebrae through which the spinal cord roots pass.
• Compression of the nerve fibers at the root of the spinal cord leads to interruption of impulse transmission and subsequent neurological symptoms.

Changes in cartilage composition occur gradually over a long period of time.Prompt preventive and therapeutic measures can slow the progression of the disease.

reason

Lumbar osteochondrosis is a multi-etiological disease caused by a variety of causes:

• Genetic predispositions that determine the nutritional characteristics of cartilage tissue at the genetic level.
• Diseases of the endocrine, digestive and cardiovascular systems.
• Inflammatory autoimmune diseases affecting spinal joints (rheumatoid arthritis, systemic lupus erythematosus, rheumatism).
• Human metabolic disorders.
• Systemic heavy physical labor, weight lifting, which increases the load on the spine.
• Previous injury to the spine, particularly to the lumbar area (a cause of disruption of the relationship between the components of the vertebrae and subsequent malnutrition and degeneration).
• Congenital abnormalities or defects of the spine.

The negative impact of the cause is more likely to be recognized in the context of the following risk factors:

• Weight gain increases the load on the spine.
• The human body systematically maintains a standing posture for long periods of time.
• Incorrect posture.
• Hypothermia, including in the back.
• Systematic stress, lack of sleep, and unreasonable work and rest schedules.

Understanding the causes and risk factors will help take effective preventive measures.

Symptoms of lumbar osteochondrosis

The following characteristic symptoms may indicate osteochondrosis:

• Lower back pain initially occurs when the load on the spine increases.Then it becomes persistent, has a pulling or painful character and gradually intensifies.
• Pain radiates to the leg on the side where the root of the spinal cord is compressed.
• Increased tension (tension) in the lumbar back muscles.
• Decreased muscle strength in one or both legs.
• Periodic "tingles" in the back caused by localized hypothermia and physical exertion.
• Loss of skin sensitivity on one or both legs, along with numbness and tingling.
• "Cold feet" - The skin feels cold to the touch due to spasm of arterial blood vessels due to compression of the autonomic nerve fibers at the root of the spinal cord.
• Impaired sweating - the skin of the feet becomes dry or, conversely, sweating increases.
• Skin peeling in areas of sensitive disorder due to violation of autonomic innervation.

Osteochondrosis is a chronic disease.Clinical symptoms gradually worsen over a long period of time.After a period of improvement (remission), the pathological condition worsens, accompanied by an increase in clinical symptoms.After exposure to predisposing factors (hypothermia, physical and emotional stress, stress), pain may increase dramatically, resulting from an inflammatory response and swelling of the soft tissues at the base of the spinal cord.

Depending on the prevailing symptoms, several clinical forms of the disease are distinguished:

• Lumbodynia is periodic paroxysmal pain in the lower back that develops after exposure to provoking factors.
• Lumboischalgia – pain occurs in the lower back and radiates to the buttock or legs.
• Radiculitis is a pathological process accompanied by compression of one or more roots, while the clinical picture is dominated by neurological symptoms, including impaired skin sensitivity and decreased muscle strength.
• Radiculoischemia - compression affects the arterial vessels, and severe motor disturbances develop.

Each clinical form of osteochondrosis does not develop in isolation; they are usually combined with each other. As it progresses, the person's condition worsens. Severe destruction of cartilage structures can lead to disability.

diagnosis

Diagnosis of osteochondrosis of the lumbar spine is based on visualization of changes in the vertebrae, intervertebral discs and soft tissues.

For this purpose, several instrumental research methods are prescribed:

• Radiography is a technique that allows you to visualize gross changes. It has become widespread due to its accessibility.
• Computed tomography is an X-ray method that scans tissue layer by layer with high resolution, allowing you to see the smallest changes.
• Magnetic Resonance Imaging - Visualization of tissue due to the resonance effect of the nuclei of organic substances in a magnetic field.It involves scanning layer by layer while eliminating radiation exposure from the patient's body.

Additional testing is needed to determine the nature and severity of functional changes that may occur in the body.It includes blood tests, urine tests, liver tests, kidney tests and an electrocardiogram.Based on the analysis of all test results, the doctor draws conclusions and selects appropriate treatment.

Lumbar spine treatment

The treatment of lumbar osteochondrosis is complex and includes several aspects:

• General advice and diet.
• Medication.
• Surgical intervention.

The choice of treatment direction is determined by the doctor.Based on the results of clinical and additional examinations, he determines the optimal treatment plan.

General advice and diet

Regardless of the severity of the pathological process, general recommendations that should accompany the treatment of lumbar osteochondrosis include:

• Eat a balanced diet, limit fatty fried foods, and eliminate alcohol from your diet.
• Limit strenuous physical activity, including holding the body in one position for long periods of time.
• Rationalize the work and rest system - take a short break after every hour of work (usually 10 minutes is enough).If you stand or sit for long periods of time at work, do some exercise during your breaks.
• Quit bad habits, as nicotine and alcohol accelerate the process of malnutrition and degeneration of cartilage tissue.
• Eliminate the influence of stress factors and negative emotions that worsen the progression of any pathological process in the body.

Following the general recommendations can prevent the progression of pathological processes and increase the effectiveness of other areas of treatment.

drug treatment

The drug is prescribed during conservative treatment of osteochondrosis.

Use drugs from different pharmacological groups:

• Nonsteroidal anti-inflammatory drugs - Reduce the severity and pain of tissue inflammation.Prescribes the intensity to reduce the worsening manifestations of osteochondrosis.
• Muscle relaxants - Medications that reduce the tone of the striated muscles of the spine, thereby reducing tissue tension and pressure at the base of the spine.
• Adrenal hormones and glucocorticoids – reduce inflammation.
• Diuretics - reduce the severity of soft tissue edema in areas of spinal structures affected by pathological processes.Therefore, the manifestations of pathological processes are reduced and the damage to the roots of the spinal cord is reduced.
• Chondroprotectants are medications that protect cartilage tissue from damage and aid in its partial repair.
• B vitamins - normalizes the metabolic processes of nervous tissue, improves the functional status of spinal cord roots damaged after strangulation.
• Vitamin C (ascorbic acid) - improves the condition of the microcirculatory structure and has an antioxidant effect, which is achieved by binding and neutralizing free radicals ("fragments" of organic molecules that contain unpaired electrons and damage the structure of cell membranes).

The dosage and duration of medication are determined by the attending physician based on study results and the effectiveness of previous treatments.

surgical intervention

If there are significant changes in the osteochondrosis of the lumbar spine, and if there are still no necessary results after conservative treatment, surgical treatment is required.Its purpose is to eliminate the defects of the altered cartilage tissue through subsequent plastic surgery.In modern medical facilities, surgical procedures are performed using minimally invasive endoscopic techniques.In addition to surgical treatment, medications are also required to help speed up the healing process after surgery and avoid complications.By using modern minimally invasive techniques, patients' hospital stays can be significantly reduced.

prevention

Preventing the development of lumbar osteochondrosis includes the following simple recommendations.It is important to limit the load on the spine, give up bad habits, arrange work and rest time reasonably, and ensure adequate sleep.The aim of the diet is to limit fried, high-fat foods and ensure an adequate supply of vitamins, minerals and plant fibers.This will normalize the functional status of the digestive system and improve the nutrition of the cartilage structures of the musculoskeletal system, slowing down degenerative processes.

The prognosis for life with lumbar osteochondrosis is good.The disease is characterized by gradual progression.In the absence of treatment, the clinical manifestations of osteochondrosis are accompanied by an exacerbation of symptoms.At the same time, the person's condition worsens and symptoms become permanent.They cause severe discomfort and reduce quality of life.To avoid the progression of negative manifestations, you should seek prompt qualified medical help.