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Lumbar osteochondrosis

The causes of lumbar osteochondrosis

Lumbar osteochondrosis is a chronic disease that develops as a result of a degenerative-dystrophic process in intervertebral discs.The disease is widespread and in most cases people from 25 to 40 years old.

According to statistics of back pain, at least once in his life, every second adult experiences, while in 95% of cases they are due to osteochondrosis of the spine.

Patients with severe lumbar osteochondrosis, with constant pain and other manifestations, are recognized as temporary disabilities.If their condition does not improve within four months, the issue of creating a disability group is resolved.

Lumbar osteochondrosis is a serious medical and social problem, as the disease mainly affects people of the largest working age and in addition, in the absence of treatment, can cause hernia to form the intervertebral disc.

Causes and risk factors

The factors predisposed to the development of lumbar osteochondrosis are:

  • Abnormalities of the structure of the spine;
  • Lumbilization is a congenital pathology of the spine, characterized by the separation from the sacrum of the first vertebra and its transformation into the sixth (additional) lumbar;
  • Sacralization is a congenital pathology in which the fifth lumbar vertebra feeds on sacrum;
  • the asymmetrical location of the joint cracks of the intervertebral joints;
  • pathological narrowing of the spinal canal;
  • reflected spondioogenic pain (somatic and muscle);
  • obesity;
  • A sedentary lifestyle;
  • prolonged exposure to vibration;
  • systematic physical strain;
  • Smoking.

Adverse static loads, combined with one or more risk factors, lead to a change in the physiological properties of the jacket of the fibrous disk, playing a major role and ensuring the mobility of the spine.The basis of this process is the depolimization of the polysaccharides, which leads to loss of moisture with tissue from the reactive nucleus.As a result, the cool nucleus and with it the fibrous disc loses their elastic properties.More mechanical loads cause a protrusion of the fibrous ring that has lost the elasticity.This phenomenon is called convexity.Cracks appear in the fibrous core through which fragments of the strong (prolapse, hernia on the intervertebral disc) fall.

The long compression of the nerve roots, innervating certain organs of the abdominal cavity over time, leads to a deterioration of their functioning.

The volatility of the spinal segment is accompanied by reactive changes in the bodies of adjacent vertebrae, intervertebral joints and develops accompanying spondyl arthrosis.Significant muscle contraction, for example against the background of physical activity, leads to shift of the vertebrae bodies and impaired nerve roots with the development of radicular syndrome.

Osteophytes may be another cause of pain and neurological symptoms with lumbar osteochondrosis - bone growths of processes and vertebral bodies that cause Royshold syndrome or compression compression myelopathy).

Forms of the disease

Depending on which structures are attracted to the pathological process, lumbar osteochondrosis is manifested clinically by the following syndromes:

  • Reflex- Lumbalgia, Lumboichalia, Lumbago;Develop against the background of reflex surge of the back muscles;
  • Compression (spinal, vascular, radicular)- their development leads to compression (compression) of the spinal cord, blood vessels or nerve roots.Examples are lumbosacral radiculitis, radiculoichemia.

Symptoms of lumbar osteochondrosis

With lumbar osteochondrosis, the symptoms are determined by which the structures are attracted to the pathological process.

Lumbago is found under the influence of hypothermia or physical overvoltage, and sometimes for no apparent reason.The pain occurs suddenly and shoots.It is enhanced by sneezing, coughing, body turns, exercise, seat, standing, walking.In a lied position, the pain weakens significantly.Sensitivity and reflexes are preserved, the volume of movements in the lumbar region is reduced.

In palpation, they observe:

  • soreness in the lumbar region;
  • spasm of paravertebral muscles;
  • Equalization of lumbar lordosis, which in many cases is combined with scoliosis.

Nerve roots tension with lumbar is negative.When they raise a straight leg, patients indicate an increase in lower back pain rather than their appearance in an elongated lower limb.

Often in lumbar osteochondrosis there is a repeated onset of pain attacks, which become more and more intensive and long.

With lumbaria, the clinical picture looks like lumbago, however, an increase in the intensity of pain occurs within a few days.

In the lumbar form, patients complain of lower back pain, which radiates to one or both lower limbs.The pain spreads along the ass and back of the thigh and never reaches the legs.

Vasomotor disorders are characteristic of lumbar puncture:

  • changes in the temperature and color of the skin of the lower limbs;
  • feeling of heat or chill;
  • Disruption of blood supply.

The development of lumbar compression syndromes is clinically manifested by the following symptoms:

  • Dermatomic hypealgesia;
  • shooting pain;
  • Weight loss or complete loss of deep reflexes;
  • Peripheral paresis.

With compression syndromes, the pain is exacerbated by tilting the body, sneezing and coughing.

Diagnostics

The diagnosis of lumbar osteochondrosis is based on the clinical picture of disease methods, laboratory and instrumental studies.

In blood tests against the background of lumbar osteochondrosis, it may be noted:

  • reduction in calcium concentration;
  • ESR increase;
  • Increasing the level of alkaline phosphatase.

In the diagnosis of lumbar osteochondrosis, the radiological examination of the spine is of great importance.

The long compression of the nerve roots, innervating certain organs of the abdominal cavity over time, leads to a deterioration of their functioning.

X -Ray features confirming the diagnosis are:

  • change in the configuration of the affected segment;
  • Pseudospondilastes (displacement of vertebrae connected);
  • Deformation of closing plates;
  • Equalization of the intervertebral disc;
  • The uneven height of the intervertebral disc (a symptom of the spacer), which is associated with asymmetric muscle tone.
How to recognize the presence of lumbar osteochondrosis

Also, in the diagnosis of lumbar osteochondrosis are used in the presence of indications:

  • Myelography, calculated or magnetic tomography for refusal - are necessary for persistent symptoms, development of neurological deficiency;
  • Scintigraphy (examination of the accumulation of the bone system of phosphorus, melted technology-99)-performed in the case of suspicion of a tumor or infectious process, injury to the spine.

The differential diagnosis of lumbar osteochondrosis is performed with the following diseases:

  • Spondylolistz;
  • Dysgormonary spondylopathy;
  • Ankylosing spondylitis (ankylosing spondel);
  • Infectious processes (inflammation discs, osteomyelitis of the spine);
  • non -plastic processes (primary tumor of the spine or its metastatic lesions);
  • rheumatoid arthritis;
  • Deformation of osteoarthrosis of the hip joint;
  • Reflected pain (diseases of the internal organs and large blood vessels).

Treatment of lumbar osteochondrosis

With lumbar osteochondrosis, they usually adhere to the following treatment tactics:

  • bed rest for 2-3 days;
  • the adhesion of the affected spine segment;
  • strengthening the muscles of the back and abdomen (creating the so -called muscle corset);
  • Impact on pathological myofascial and myotonic processes.

Lumbago is found under the influence of hypothermia or physical overvoltage, and sometimes for no apparent reason.

In most cases, conservative treatment of lumbar osteochondrosis is performed, including the following measures:

  • muscle infiltration with a solution of topical anesthetics;
  • administration of non -steroidal anti -inflammatory drugs;
  • adoption of desensitizing agents;
  • Vitamin therapy;
  • administration of tranquilizers and antidepressants;
  • Manual therapy, massage;
  • Physiotherapy Physical Education;
  • acupuncture;
  • Postisometric relaxation.

The absolute indications of surgical treatment of lumbar osteochondrosis are:

  • acute or subacute compression of the spinal cord;
  • The development of ponytail syndrome, characterized by impaired pelvic function, sensitive and motor disorders.

Medical gymnastics for lumbar osteochondrosis

Exercise for lumbar osteochondrosis

In the complex treatment of lumbar osteochondrosis, a significant role belongs to physiotherapy exercises.Regular classes allow to normalize the muscle tone of the muscles of the paravertebral, to improve the metabolic processes in the tissues affected by the pathological process, and in addition to form a well -developed muscle corset, which can maintain the spine in the correct position, to remove excess static loads from it.

In order for gymnastics with lumbar osteochondrosis to lead to the greatest effect that adheres to the following principles:

  • the regularity of the classes;
  • gradually increasing the intensity of exercise;
  • Avoid fatigue during the lesson.

Physical education should deal with the management of an experienced instructor who will choose the most effective exercises for a particular patient and control the correctness of their application.

According to statistics of back pain, at least once in his life, every second adult experiences, while in 95% of cases they are due to osteochondrosis of the spine.

In addition to the instructor hours, you should perform a complex of morning gymnastics daily, which includes special exercises with lumbar osteochondrosis.

  1. Relaxation and contractions of the abdominal muscles.The starting position stands, the legs are shoulder width, the arms of the body are lowered.Make a smooth breath, relaxing the muscles of the anterior abdominal wall.During exhalation, draw as much as possible, straining the muscles of the press.The exercise should be repeated before the onset of mild fatigue.
  2. Movement of the head with bending of the spine.The starting position of the knees resting on the floor from the back is right.Slowly lift your head and bend from behind.To hold on to this position for a few seconds and then return to your original position smoothly.Repeat at least 10-12 times.
  3. "Pendulum".The starting position, located on the back, arms on the body, legs are bent at right angles to the knee and hip joint.Turn your legs to the right and left with swinging neighborhoods, filmed movements, trying to pick up the floor.At the same time, shoulder blades cannot be torn off the floor.
  4. "Boat".The starting position of lying down the stomach, the hands are extended forward.Tear off the upper body and legs from the floor, bending from the back.Keep in this position for 5-6 seconds and slowly return to the starting position.Complete 10 times.

Possible consequences and complications

The main complications of lumbar osteochondrosis are:

  • the formation of intervertebral hernia;
  • vegetascular dystonia;
  • Spondylolis, Spondylolistz;
  • osteophitosis;
  • spondylartrosis;
  • Spinal gateway stenosis, leading to compression of the spinal cord and capable of causing constant loss of working capacity and reducing quality of life.

The long compression of the nerve roots, innervating certain organs of the abdominal cavity over time, leads to a deterioration of their functioning.As a result, patients have intestinal dysfunctions (constipation, diarrhea, flatulence) and pelvic organs (urinary disorders, erectile dysfunction, frigidity, infertility).

Forecast

Lumbar osteochondrosis pain syndrome occurs in the form of remissions and exacerbations.Lumbago lasts for 10-15 days, after which the patient's condition improves, the pain disappears.Aparticular secondary diseases can prevent a favorable result.Often in lumbar osteochondrosis there is a repeated onset of pain attacks, which become more and more intensive and long.

In the complex treatment of lumbar osteochondrosis, a significant role belongs to physiotherapy exercises.

Patients with severe lumbar osteochondrosis, with constant pain and other manifestations, are recognized as temporary disabilities.If their condition does not improve within four months, the issue of creating a disability group is resolved.

Prevention

The prevention of the development of osteochondrosis of the spine are the following measures:

  • Smoking refusal;
  • normalization of body weight;
  • improving the overall physical condition, an active lifestyle;
  • Avoiding provocative conditions (lifting weights, sharp movements, turns, slopes).