What is osteochondrosis of the lumbar spine?

Osteochondrosis of the lumbar region is a pathology of the musculoskeletal system, accompanied by degenerative-dystrophic changes in the bone tissue and impairment of the functioning of the lower five vertebrae (from 20 to 24). The disease causes discomfort to the patient and is characterized by specific symptoms: pain, stiffness of movements. Osteochondrosis of the lower back occurs in waves, with periods of exacerbations and remissions. 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 a competent integrated approach, osteochondrosis can be successfully treated.

Main causes of pathology

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

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

• wear high-heeled shoes;
• carry a bag or backpack on one shoulder without alternating them;
• sleeping or resting for a long time in an uncomfortable position;
• sedentary work;
• weight lifting.

Those at risk for developing osteochondrosis include older adults who are characterized by naturally destructive changes in cartilage and bone tissue, professional athletes who train daily and intensively, pregnant women, whose center of gravity shifts as theythe fetus grows and the load on the lower back increases significantly, office workers, forced to spend a lot of time in a sitting position.

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

• previous injuries to the musculoskeletal system;
• curvature of the spine;
• flat feet;
• congenital dislocation or subluxation of the hip joint;
• autoimmune disorders;
• inflammation of joint tissues;
• pathologies of the circulatory system;
• endocrine diseases;
• obesity.

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

Osteochondrosis of the lumbar spine: symptoms

The 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 noticeable with significant damage, gradually and slowly. In the early stages it is a moderate discomfort during exercise, in the later stages it is a sharp, unbearable pain. Clinical signs are pronounced in the acute phase. During the remission period they fade, and in the initial stages this happens even without treatment.

Osteochondrosis of the lumbar spine - symptoms:

• pain in the affected area of the spine;
• radiating pain upwards to the shoulder blade area or downwards to the pelvis and hip joints;
• persistent feeling of tension in the lower back;
• difficulty bending and turning the body;
• sloppy;
• lameness;
• muscle weakness or, conversely, increased tone;
• tingling sensation.

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

Stages of the disease

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

1. First phase. The first structural and functional changes begin. The intervertebral discs dry out and can rupture. Symptoms at this stage are minor. Many patients mistake them for tiredness after a day at work, wearing uncomfortable shoes, or exercising. The main signs of early osteochondrosis are mild discomfort in the lower back, which increases with bending and turning. A slight pain is possible, which will disappear on its own after rest.
2. Second phase. The height of the intervertebral discs decreases, the bone structures become closer together. This causes a new set of symptoms: stiffness during movement and pain. The pain becomes prolonged and intense and may radiate to the pelvis and legs.
3. Third phase. At this stage, the vertebrae become deformed. Protrusions form: the intervertebral discs swell in the area of the spinal canal, but the fibrous rings remain intact. The main symptoms are intense pain, annoying even at rest, decreased sensitivity, creaking and clicking during movement, tingling and numbness in the lower back.
4. Fourth phase. Pathological changes continue to progress. The functions of the vertebrae are lost. Hernias form. Osteophytes, or bone growths, are formed. Blood vessels can be pinched and nerve fibers can be pinched. Against the background of deterioration of blood circulation, the functioning of the pelvic organs is disrupted. In men the risk of erectile dysfunction increases, in women interruptions in the menstrual cycle are observed. Advanced osteochondrosis is manifested by severe lumbago in the lower back, lameness, reduced mobility up to complete immobility and increased temperature.

If you are worried about lumbar osteochondrosis, its treatment will directly depend on the stage at which the disease is diagnosed. In the initial stages, the doctor has many more recovery methods and techniques in his arsenal. Detection of degenerative-dystrophic changes in the initial stages allows you to treat the pathology conservatively, without resorting to surgical intervention.

Forms of pathology

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

1. Lumbago. It is a sharp, stabbing pain that makes movement impossible. The causes of the pain may be pinched nerves or muscle spasms.
2. Lumbonia. This is a long-term aching pain. It is characteristic of the stage of formation of protrusions and hernias. Additionally, discomfort may be associated with a sprain of the ligaments.
3. Sciatica. This is a sharp 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 based on the accompanying symptoms. The patient may be diagnosed with:

1. 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 sensation are expressed. Possible decrease in muscle tone, impaired reflexes, tingling in the legs.
2. Lumbar discogenic osteochondrosis. This is a serious condition in which the patient is limited in movement. The lower back and limbs are numb. Other symptoms are general weakness, fever, involuntary urination and, if the illness is prolonged, weight loss.

Danger of spinal diseases

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

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

To prevent concomitant pathologies, it is necessary to start treatment of osteochondrosis immediately from the moment of detection. With a competent approach to therapy, it is possible to stop or significantly slow down the destruction of bone and cartilage tissue.

Methods for diagnosing pathology

Osteochondrosis of the lumbosacral spine must be differentiated from other pathologies of the musculoskeletal system, which can manifest themselves with similar symptoms. The main stage is a consultation with a neurologist, orthopedist or surgeon. The doctor clarifies complaints, collects anamnesis, carries out a physical examination, paying attention to the characteristics of the patient's posture and posture, the nature of his working activity, bad habits and concomitant diseases.

For the most accurate diagnosis, instrumental techniques are used:

• MRI;
• radiography;
• myelography with contrast medium;
• Multislice CT.

Each of the diagnostic procedures allows the doctor to evaluate the condition of the lumbar and sacral spine at the moment. The images clearly show structural changes in the vertebrae, indicating the stage of osteochondrosis. Based on the data obtained, the specialist makes a decision on the tactics for further management of the patient.

Laboratory diagnosis is not of critical importance, however, if indicated, studies may be recommended. In particular, if lumbar osteochondrosis is diagnosed, treatment may be prescribed based on the results of blood tests. They are necessary to clarify the intensity of inflammatory processes in the muscle fibers adjacent to the spine.

Lumbar osteochondrosis: treatment

The fight against pathology is carried out under the supervision of a neurologist and begins after a full diagnosis, when the degree and extent of tissue damage is determined. Modern medicine offers a number of effective conservative methods. If their use does not lead to the expected result, doctors resort to surgery.

Lumbar osteochondrosis: treatment with physiotherapeutic methods

All physiotherapeutic techniques are good because they act comprehensively on the sacral and lumbar spine. This approach allows you to deal with pain, reduce inflammation and restore normal blood circulation.

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

• electrophoresis: exposure of the problem area to constant electrical pulses with the possibility of using drugs for external use;
• diadynamic therapy - a variant of electrotherapy using pulsed currents;
• 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 pulses;

It is important to consider two nuances. First, the effect of physiotherapy treatment is noticeable only after a course of procedures, the duration of which is selected individually for each patient. The second is that physiotherapy as an independent method works for early-grade osteochondrosis. For large lesions it is recommended as an auxiliary technique in addition to medical and surgical treatment.

Lumbar osteochondrosis: treatment with drugs

Pharmacotherapy for injuries of the lumbar and sacral spine is aimed at relieving acute pain and suppressing inflammatory processes. The method is relevant in the acute phase, when symptoms interfere with a full life.

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

• NSAIDs (systemic and local) to suppress inflammation in the vertebrae and adjacent tissues;
• muscle relaxants to relieve muscle spasms;
• angioprotectors to improve blood circulation;
• chondroprotectors to protect the cartilaginous tissue of the intervertebral discs from destruction;
• B vitamins to improve nerve conduction;
• analgesics for sharp stabbing pains that limit mobility.

Physical therapy as a method of treating pathology of the sacral and lumbar regions

Intense training for osteochondrosis is strictly prohibited, but it is not possible to completely give up physical activity. On the contrary, exercises of moderate strength and duration help restore blood circulation and reduce pain.

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

1. Train with an instructor. The trainer will show you which exercises are allowed in a particular situation and make sure they are performed correctly. Even the smallest technological flaws can significantly reduce the effectiveness of training or even cause harm.
2. Prepare carefully for the lesson. Before exercise, it is recommended to warm up the muscles: you can gently massage the lower back and sacrum.  
3. Dose the load strictly. The lower back is a vulnerable area. To avoid overexertion, you need to monitor the duration of the lessons. Their optimal duration does not exceed 20 minutes.
4. Gradually increase the intensity of the exercise. For beginners without experience, simple exercises and short programs are suitable. Those who have been practicing physical therapy for a while can move on to more complex options.
5. Remember to be regular. A one-time workout will not bring visible improvements. Pain in the lumbar and sacral spine decreases if the patient performs physical therapy regularly, preferably twice a week.
6. Consider the contraindications. Physical therapy has proven to be a safe method to help with osteochondrosis, but there are limitations. You should stop exercising if you feel unwell: fever, weakness or increased temperature.

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

1. In the acute period. Only smooth and slow movements are allowed. If the pain increases during exercise, you need to stop and give the joints rest.
2. In the subacute period. The pain syndrome subsides, 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.
3. In remission. We allow the whole range of exercises for pathologies of the lumbar spine, but it is important to remember that excessive effort is fraught with a new exacerbation of the disease.

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 an instructor, it is not forbidden to repeat the exercises at home. For training you will need a gymnastic mat, a roller and a ball.

Modern physical 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 rehabilitation system transforms rehabilitation into an exciting competition with oneself. 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 monitor even the slightest progress in the patient's condition. The system evaluates the result of each exercise performed and the doctor can see the progress from one workout to another. Knowing their success also motivates patients to try harder and not give up.

Manual therapy

Good results can be achieved if physical therapy and medications for lumbar pathology are integrated with manual therapy. The method allows:

• eliminate hypertonicity of muscle fibers;
• relieve pain;
• restore blood supply to the lumbar and sacral areas;
• improve the course of metabolic processes.

Manual therapy is an effective way to adequately redistribute the load on the spine and protect yourself from further destructive changes. The positive aspect of this method is that it not only relieves pain, but also prevents neurological disorders that often develop against the background of lumbar osteochondrosis.  

Chiropractors currently combine massage and physical therapy methods, such as tecar therapy. Electromagnetic waves penetrate deep into bone tissue and allow you to relieve pain attacks and quickly restore mobility.  

Surgical methods

Osteochondrosis of the lumbar spine, treatment of which with drugs, physiotherapy and exercise therapy is not always effective, significantly complicates the patient's life. In some cases, only surgery is applicable to eliminate pain and restore back mobility. Modern methods and technological equipment allow performing minimally invasive operations with a shortened rehabilitation period.

For osteochondrosis the following methods of intervention are relevant:

• endoscopic excision of intervertebral hernia - using microsurgical instruments and a built-in camera;
• transfacial removal of intervertebral hernia - using neurosurgical tube dilators;
• laminectomy – surgical removal of pathologically changed bone processes;
• microdiscectomy – elimination of the hernia 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 with conservative methods.

Disease prevention

The symptoms of osteochondrosis cause discomfort, and treatment of the pathology can take a long time. It is much more effective to protect the vulnerable lumbar region from excessive strain in advance. For preventive purposes we recommend:

1. Organize your workplace properly during office work. The back of the chair should support your lower back and the table should be suitable for the height.
2. 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 foot deformation and flat feet, one of the factors
3. risk of osteochondrosis.
4. Exercise. Lifting heavy objects should be avoided. Swimming, walking and cardio training are useful if there are no contraindications.
5. Follow a balanced diet. The diet must contain foods that are sources of calcium, phosphorus and B vitamins. These are fish, dairy products, green leafy vegetables and cereals. These substances are necessary to strengthen all elements of the joints and support the nervous system.
6. Make sure you get enough sleep. It is best to sleep on an orthopedic mattress of medium hardness. It will provide an anatomically correct posture in which the body rests from daily stress.
7. Check your body weight. Obesity is one of the provoking factors. If the 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. This is why timely diagnosis is extremely important. If you are worried about back pain and the pictures reveal destructive processes in the early stages, 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 surgical intervention. Physical therapy can be used as an additional measure of assistance in any form and at any stage.