Destructive disorders can develop in any section of the spine, but the high load on the lower back as a result of a person’s straightforces determines the appearance of changes in this segment.Osteochondrosis is accompanied by pain in the lower back.Only a doctor can correctly determine the symptoms and treatment of pathology.In therapy, medicines and physical exercises are used, in advanced stages, surgery may be needed.As an addition to the main treatment, the use of folk remedies is allowed.
What is osteochondrosis
With osteochondrosis, a pathological change begins - with a pulpoic nucleus of intervertebral discs with a gradual transition to the tissue of a fibrous ring.It weakens, cannot withstand an increasing load, as a result of which a partial, and then complete movement of the disk from its physiological position begins.This happens when fibrous fibers do not withstand increasing pressure and break.
As the disk structure destroys, the destruction of nearby tissues is progressing.The involvement of the nearest vertebrae, their joints and ligaments begins in the pathological process.Any vertebra has a spongy substance from the inside and an external compact bone contour consisting of records.The outer layer provides hardness and allows you to withstand heavy loads.The vertebra also has a red bone marrow responsible for hematopoiesis.
For a long time, with osteochondrosis, complex vascular and biochemical changes occur.Bone tissue is constantly changing: some cells are destroyed, new ones come in their place.Normally, with constant load, the formation of more durable and solid cells is stimulated.Therefore, with excessive overloads, the predominance of dense fabric is formed.
The causes of pathology
Features of modern life and a sharp decrease in human motor activity lead to a weakening of muscle fibers and a decrease in their tone.In an average person, the back in the day is mostly a bent position, which leads to overstretching of the flexion muscles.This factor is considered the main of provoking degenerative changes.
There are several theories of the origin of osteochondrosis:
- Involutionary.The etiology of the disease is the wear of the discs.This is especially facilitated by a sedentary lifestyle and the presence of bad habits.
- Muscle.Violations in the structure of the spinal column are due to underdevelopment or weakening of the muscle corset of the back or constant muscle cramps, as well as inflammatory processes in them and the ligamentous apparatus.It is believed that the incorrectly created muscle movement stereotype leads to degeneration.It contributes to the constant excessive overload of the involution of cartilage and other spine structures.
- Autoimmune.The process of destruction of vertebrae and intervertebral discs develops according to the same scheme as rheumatoid arthritis.Such an assumption is considered close to the truth, since biochemical disorders for collagenosis are very similar to changes in the discs of the discs, leading to a deterioration in tissue and dystrophy.
The influence of the pathology of internal organs, as well as the presence of constant microtraumas in the development of osteochondrosis, has also been proven.
There is a theory about a hereditary predisposition of a person to this ailment;Some doctors say that violations are sometimes caused by a change in metabolic processes and deviation in the work of internal secretion.
In many patients with pronounced disorders, chronic foci of infection are determined.
In connection with slow progression, it is read that osteochondrosis develops under the influence of several etiological moments at once.
Development mechanism
All the symptoms that are characteristic of a dystrophic disorder in the lumbar region can be divided into two large groups: internal (spinal) and extravertebrial.
The latter are divided into reflex and compression.Depending on the severity of the lesion and the presence of complications, four stages of the disease are distinguished:
- The fibrous ring under the influence of excess loads and other factors begins to change the structure: cracks are formed on it.The substance of the jacket nucleus penetrates them.Reflex reactions occur as a result of irritation of fibers of the nerve innervating the periosteum, ligamentous apparatus, fibrous ring.Its irritation occurs as a result of pressure when a hernia is formed, local edema or inflammation.Such a violation leads to the appearance of vasomotor or dystrophic changes.As a result, a person experiences severe pain, permanent or shooting.Reflex disorders in chronic osteochondrosis in the lumbar segment lead to the development of lumbago and lumbalgia.And myofascial pains lead to limiting movements.Radiculopathy acts as a compression syndrome, which most often accompany the damage to the lumbosacral segment.
- The progression of pathology leads to an increase in the prolapse of the intervertebral disc with its penetration into the epidural region.The vertebrae draw together and exert different pressure on the nerve roots.It can be expressed in constant irritation or severe compression.These manifestations mark the second stage with the development of discogenic radiculitis.Most often, such a phenomenon is observed from the fourth lumbar to the first sacral vertebra.
- This stage is characterized by a continuation of the pressure of the hernia on the nervous and vascular bundle.This ends with the appearance of paresis or paralysis in the extensor muscle of the foot.At the same time, the pain syndrome decreases or disappears.
- With the last degree, the blood supply and innervation of the spinal cord is disturbed with the appearance of discirculatory myelopathy.Changes become stable and are poorly lended to drug adjustment.
Clinical symptoms and syndromes
Manifestations of degenerative deviations in the lower back zone are manifested by pain of various intensity and duration.In addition, a person feels fatigue, which increases by the end of the day, he sleeps poorly and becomes irritable.At first, the symptoms pass or are reduced after a night rest or stay in a horizontal position, but then painful sensations are observed in the morning.Because of this, the patient is forced to reduce his physical activity.
The problems of the lumbar region lead to irritation and inflammation of the nerve endings, including the innervating organs of the pelvis.Therefore, with advanced pathology, urination is impaired, problems in the work of the internal genital organs are noted.In men, impotence develops against this background.
Irradiation of pain and impaired sensitivity concerns the lower extremities.The patient notes a burning sensation and “crawling of goosebumps”, the skin on the legs becomes pale, dry and peel off.
Osteochondrosis of the lumbar spinal column is manifested by several syndromes, the degree of manifestation of which varies in various patients.
Koreshka
The pain in this case occurs as a result of the lesion of the roots, it is acute, localized in the area of damage and goes into the zone of the lower leg, buttocks, hips and feet.To reduce unpleasant sensations, a person changes the usual gait and leans towards the reverse side of infringement.The pain is accompanied by sweating, which is replaced by chills, intensifies when trying to sharply move after a state of rest.
Due to a decrease in muscle tone and their gradual atrophy, it becomes impossible to perform ordinary work.In an advanced stage, paralysis of the limb develops, violation of the work of internal organs in the pelvis.
Ischemic
Osteochondrosis is accompanied by damage to not only nerve endings in the lumbar region, but also blood vessels.Their compression leads to spasm, which becomes constant as it worsens.Clinically, this phenomenon is manifested in the form of intermittent chroma.
The lack of nutrients and oxygen occurs in the organs of the pelvis.This exacerbates the problems of urination, defecation and potency even more.
Pain
The appearance of pain is the earliest sign of osteochondrosis.Its intensity depends on the degree of damage.At first, the pain is short in nature, disappearing after rest, but from the very beginning of the disease to be long and aching.The aggravation of pathology leads to the appearance of sharp fires with radiation in the leg, groin, buttocks.
At a late stage, suffering is caused not only by physical effort, but even a cough or sneezing.In the lumbar region, muscle hardening is palpated, which are in a constant spastic state.
Vertebrate
With constant pain, innervation and blood supply, significant deformation occurs.Rotting is noticeable not only in the field of the pathological process, the architectonics of the spinal column are disrupted.Muscle tone decreases, pelvis and pelvic skew occur.The gait changes, becomes uncertain.Gradually, a restructuring of the entire musculoskeletal system occurs.
Complications of osteochondrosis
If you do not treat the ailment in the early stages, then complications are gradually developing, many of which significantly reduce the quality of life and even reduce its term.A neglected dystrophic process leads to the following violations:
- muscle weakness, atrophy and asthenia;
- violation of urination and defecation (incontinence);
- the development of severe deformation of the spine in men in hard physical work and in women during pregnancy;
- violation of potency in men;
- decreased blood flow and the development of ischemia;
- protrusion and hernia of the intervertebral disc;
- spondylarthrosis (growth of spiked processes);
- paresis of the foot;
- spondylosis.
An important point when considering the clinic of lumbar osteochondrosis is the presence of reflected pain.Injection of nerve beams leads to irritation of internal (visceral) organs, causing pain and functional of function in them.This explains the development of such manifestations as difficulty breathing, arrhythmias, intestines that accompany the pathology of the spine.
Methods of treatment
For the treatment of osteochondrosis of the lumbar spine, various methods are used.
Medication
The drugs for the treatment of the disease are NSAIDs.They allow you to simultaneously eliminate the process of inflammation and reduce the pain syndrome.Simultaneously with drugs for internal use, local therapy with ointments and gels with anti -inflammatory effects is recommended.Most often, sodium diclofenac is used, ibuprofen in tablets or capsules.Sometimes, with intolerance to anti -inflammatory drugs, analgesics are used.
With severe pain, local blockades with novocaine or lidocaine are held.In some cases, with pronounced inflammation simultaneously during the paravertebral blockade, glucocorticoids are used with novocaine.This allows you to influence afferent conductivity and normalizes the reflex activity of the overlying parts of the nervous system.
A good result in muscle spasm is shown by central muscle relaxants, a typical representative of this class is Midokalm.These drugs are combined with non -steroidal anti -inflammatory, enhancing the effect of anesthesia and restoration of movement in full.
Additional treatment with medicines includes sedatives and drugs to normalize the work of the nervous system.For this, it is sometimes recommended to take antidepressants, antipsychotics or tranquilizers.
Vitamin complexes that include group B, vitamin D and calcium help to improve nervous conductivity and metabolic processes.To restore the structure of cartilage, prolonged use of chondroprotectors is used.
Physiotherapy
Modern physiotherapy techniques are an integral part of the successful treatment of osteochondrosis of the lumbar spine.These include:
- The use of currents of various frequency and intensity.Typically, a current effect is used with a force of up to 100 mA, amplipulse (modulated currents), darsonvalization, electrophoresis with analgesic substance and proteolytic enzymes.Methods can improve blood circulation in the damage zone, restore metabolic processes, increase blood flow, and deliver the drug directly to the application point.
- Use of the laser.Its exposure reduces the activity of inflammation and pain, and when directed to parapouring points, it allows you to restore the structure of the intervertebral discs.
- UFO.With the help of irradiation by ultraviolet, warming is carried out, the production of vitamin D and the optimization of calcium metabolism.
- Magnetotherapy.It consists in the use of an induction magnet to restore regenerative processes at the level of cellular structures.
- Balneotherapy.It provides for the use of healing water and mud.To this end, the patient is recommended to take common and local baths, conduct applications and compresses.
Physiotherapy and massage
An important link in treatment is physical education.Its implementation is mandatory, but the selection of movements should be carried out by a specialist.Classes allow you to restore muscle tone, strengthen their fibers, expand the volume of movements in the spine.In order to obtain a positive result, certain rules must be observed:
- You can not perform exercises if they cause pain or excessive stress; you should start training under the control of an exercise therapy instructor;
- Physical education must be done regularly, only under this condition will the formation of a muscle corset occur;
- Do not make movements sharply and too fast, usually an average or slow pace is recommended;
- gymnastics is not carried out with exacerbation of any disease;
- In case of deterioration, you should immediately stop the exercise and consult a specialist.
It is best to select exercises that are performed in the position of lying and standing on all fours.It is useful to stretch the spine, download the press and back.For such a patient, a good method of rehabilitation after an exacerbation of osteochondrosis will be a visit to the pool.
Massage is also an effective method of therapy for osteochondrosis in the lumbar segment.
An experienced specialist will help improve metabolic processes and microcirculation in the violation zone, relieve muscle tension. The use of massage in the acute period is extended, in the presence of severe irreversible deformations, open wounds, rashes or burns on the skin.
Surgery
In the absence of the results of complex conservative therapy, it remains only to use the radical treatment method.It consists in conducting an operation on the spine in order to eliminate the compression of nerve roots and the maximum possible restoration of the mobility of the spine or stabilizing its affected segment.
Indications for the operation are:
- development of sequestered inter -back hernia;
- severe pain, which is not stopped by the use of medicines and blockade;
- full drop in the disk with the development of caudal syndrome and ischemia;
- The emergence of signs of radiculomiloichemia.
Most often, the patient is carried out by microdiscectomy, when bone tissue retains its integrity, and the rehabilitation process takes a short period of time.
There are other methods of intervention:
- endoscopic nucleotomy;
- laser vaporization of the disk;
- Plasma disk nucleoplasty.
Scientists around the world are developing for the implementation of prostheses that replace intervertebral discs.This will make it possible to rehabilitate the patient after surgery and reduce the likelihood of disability.
The use of traditional medicine
Along with the use of drugs, folk methods are used to treat pain in the lower back of the lower back.They cannot replace the full -fledged therapy of osteochondrosis, but allow remission to reach remission in complex therapy:
- At home, it is convenient to use radish or horseradish as compresses.They should be chopped on a grater, add a little home sour cream and applied to the lesion.
- You can pour boiling water on a leaf of burdock and attach to the lumbar region.Top it on top with a down scarf and hold one hour.
- Bodyaga in powder, diluted 1:30 with vegetable oil, helps well.From the mixture, a great warming compress is obtained, which should be kept for one hour.
- It is useful to rub the lower back with liquid honey.But this should be done correctly to achieve a powerful rush of blood to the sore spot.
- To remove pain in the lumbar, ointment is used.For manufacture, you need to take equal shares of ghee, camphor oil and horse chestnut powder.After thorough mixing, the product is smeared on pieces of rye bread and applied to the sore spot.
Before using any folk remedies, you should consult a doctor.
Prevention of the disease
To prevent the development of lumbar osteochondrosis and renewal of remission, the rules of prevention should be followed:
- avoid hypothermia;
- do not raise heavy objects (the maximum allowable load for a woman is 5 kg, for a man - 10 kg);
- Daily perform exercises that allow us to strengthen the muscle corset and press;
- with prolonged sitting work, take regular breaks and warm up;
- while walking always monitor your posture;
- regularly sanitize possible sources of chronic infection;
- eat properly and prevent overweight;
- Walking at a moderate pace as long as possible;
- Visit a dance group, engage in swimming, sports walking, avoiding sudden movements and strong jumps.
It is completely impossible to cure osteochondrosis, since the changes taking place in the spine are irreversible, but modern help methods help to restore the quality of life of the patient for a long period.