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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 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 elasticity and begin to dry out.

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

What is it?

When dystrophic degenerative changes appear in the tissues of the vertebrae, they begin to gradually collapse. If 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 fibrous ring begins to rupture, the intervertebral disc protrudes.This leads to pinching of the nerve endings and pain.

In the absence of adequate treatment, osteochondrosis progresses. The intervertebral discs harden, their cushioning 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

Specialists 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 fibrous ring begins to collapse. The intervertebral discs are compressed, they go beyond physiological boundaries, there is pressure on the nerve roots. Patients complain of tangible pain, which in the process of walking is given to the buttocks, thighs and legs. In addition to pain, a burning sensation, cold is possible.
  3. Fibrous rings are destroyed, during the examination, intervertebral hernias are revealed in patients. Pain constantly disturbs, regardless of the load.
  4. Bony growths are visible from the vertebrae. Cartilage atrophies, it becomes difficult for the patient to move. As a result, the lumbar spine loses mobility and flexibility and the patient becomes disabled.
They also classify osteochondrosis according to the type of disease course:
  • relapsing;
    • chronic
  • ;
  • chronically relapsing.
  • regressed (with exacerbations, the clinical manifestations of the disease decrease);
  • progressive (progressive);
  • non-progressive.

Experts distinguish such a period of osteochondrosis:

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

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

ICD 10 code

In accordance with the international classification of diseases, spinal osteochondrosis has been assigned the code M42. Juvenile (M42. 0), adult (M42. 1) and unspecified (M42. 9) osteochondrosisare distinguished separately.

Prevalence and meaning

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

Very often, people who have passed the age limit of 30suffer from osteochondrosis of the lumbar spine. Although it can be found in younger patients. Almost 80% of patients who go to doctors with complaints of pain in the lower back are diagnosed with osteochondrosis.

Examination of patients over the age of 40 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, bricklayers, loaders, 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;
  • posture problems;
  • genetic predisposition;
  • lack of sleep;
  • frequent stress;
  • constant hypothermia;
  • needs to be in an uncomfortable position for a long time;
  • poor physical activity.

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

  • natural aging processes of the body;
  • metabolic problems;
  • back injuries;
  • back problems;
  • flat feet;
  • strenuous physical activity, such as weight lifting;
  • problems with the joints of the spine (rheumatoid arthritis);
  • endocrine diseases;
  • problems with the digestive and cardiovascular systems.

Some experts believe that the propensity to develop osteochondrosis is transmitted on a 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 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.

Sciatica(inflammation of the sciatic nerve) can develop with osteochondrosis. The disease leads to severe pain, numbness in the lower back, legs. 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 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, displacement of the vertebrae leads to compression myelopathy.

Cauda equina syndrome is considered the most dangerous complication. It 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. Complaints usually appear as the disease progresses to stage 2.

The main symptoms of lumbar osteochondrosis include:

  • lower back pain that worsens as the disease progresses;
  • reduced mobility: problems appear when trying to bend, turn around, sensations when changing body position are described by patients as "electric shock", pain in many of them radiates to 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, creeping chills, tingling;
  • muscle weakness, lack of tendon reflexes;
  • drop in local temperature;
  • increased sweating;
  • pallor, dry skin in the problem area;
  • disorders of urination, sexual dysfunction (in severe osteochondrosis).

Some patients have a spasm of the arteries in the legs. But the symptoms are expressed only in the acute form of osteochondrosis. A flare-up can begin suddenly with hypothermia, awkward movements, or after strenuous physical activity.

Which doctor are you treating?

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

For experienced specialists, an 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 for detecting osteochondrosis isradiography. But to get a more accurate picture, a computer or MRI is prescribed.

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

Treatment

Physiotherapy for the treatment of lumbar osteochondrosis

Tactics of therapy are selected by the doctor based on the patient's condition, the stage of osteochondrosis and the clinical manifestations of the disease.

Your doctor may prescribe:

  • drug therapy, non-steroidal anti-inflammatory drugs, hormonal drugs, analgesics are selected;
  • blockade of drugs, analgesics, 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 stopping the acute phase of the disease, with the help of physiotherapy, it is possible to improve the effectiveness of drug treatment;
  • medical gymnastics;
  • acupuncture.

Operation required in advanced cases. Surgical intervention is prescribed in those situations when 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 lead not only to the appearance of constant severe pain, but also to cause paresis, paralysis of the lower extremities.

  • You can 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 its mobility.
  • Depending on the degree of destruction of the intervertebral discsthere are 4 stages of the disease.
  • More often this diagnosis is made in people over 30 years of age. Almost 80% of patients who go to the doctor because of back pain are diagnosed with osteochondrosis.
  • Those people who lead an inactive lifestyle are susceptible to osteochondrosis, are in an unnatural position for a long time, experience frequent physical overloads.
  • The main symptoms of osteochondrosis are pain and reduced mobility of the lower back.
  • Due to the destruction of the intervertebral discs in the lumbar spine, patients develop leg problems.
  • If left untreated, pain increases,sciatica, vertebral instability and 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 sent for x-ray, computed tomography, or magnetic resonance imaging.
  • Depending on the condition,is ​​prescribed medications, blocks, massages, manual therapy, physiotherapy, physiotherapy exercises or surgery.