The most common cause of back pain is the development of a disease of the musculoskeletal system such as osteochondrosis. If previously this pathology was found mainly in old people and less often in middle age, now osteochondrosis has become much younger, it is often diagnosed in people aged 20 to 30 years.
According to medical statistics, the disease most often affects the lumbar and lumbosacral spine.
Characteristics of the disease
Osteochondrosis is a pathology of the musculoskeletal system that affects its most important component - the spine. This is due to the fact that dystrophic changes in the intervertebral discs begin to develop.
The disease not only affects the tissues of the intervertebral discs, negative changes begin to occur in the surrounding tissues, affecting the ligaments and muscles.
The reason for the prevalence of the lumbar form of osteochondrosis is that this particular part of the spine is under the greatest physical stress.
With this disease, characteristic changes occur in the nucleus pulposus, which is part of the intervertebral disc. This disc performs damping functions.
If the water exchange in the intervertebral discs is disturbed, they become thinner, their fragility increases.
People of older age groups are the most susceptible to the pathological process, since metabolic processes in the tissues of the intervertebral discs begin to deteriorate when they reach a certain age.
Under the influence of negative changes, the boundaries of the nucleus pulposus gradually widen, it tends to enter the intervertebral space. This usually ends with the nucleus moving towards the spinal canal, as a result of which it is compressed and pinched by nerve fibers and blood vessels.
Pinched nerves are the cause of pain in osteochondrosis. There may also be a deterioration in the functioning of internal organs.
With the progression of the pathology, the pressure force on the vertebrae increases. The body seeks to compensate for the defect and the growth of bone tissue in the spine is considerably accelerated. As a result, pathological growths - osteophytes - form on the vertebrae. Ultimately, this further disrupts the functionality of the affected spine.
With advanced forms of osteochondrosis, the patient may present with paralysis of the lower limbs. Due to late access to medical care, a person can become disabled.
Causes of osteochondrosis of the lumbar and lumbosacral spine
Osteochondrosis of the lumbar and lumbosacral spine develops due to poor load distribution on the spine. If this is combined with other negative factors, the progression of osteochondrosis is accelerated, it can take more severe forms.
The disease can be caused by:
- regularly perform heavy physical work, lift heavy objects (people of certain professions, as well as athletes involved in weight lifting, are at risk);
- insufficient physical activity, which negatively affects the condition of the muscles and leads to a deterioration of blood circulation, metabolic processes and a decrease in the amount of nutrients entering the tissues;
- the patient is overweight, which leads to the fact that the spine is constantly exposed to heavy loads;
- posture and incorrect gait problems;
- the presence of birth defects or other defects of the spine or the entire skeleton; Flat feet
- can also cause the development of osteochondrosis, because in patients with deformity of the foot, its arch of the foot cannot fully absorb loads during movement, resulting in increased loads on the discsintervertebral;
- traumatic spinal cord injury;
- genetically determined disorders in the formation of bone tissue;
- age-related changes;
- infections affecting bone tissue (tuberculosis, osteomyelitis);
- inflammatory processes affecting bones and joints (including rheumatoid arthritis, ankylosing spondylitis);
- vitamin and mineral deficiency;
- exposure to harmful and toxic substances.
The most common cause of pathology is heavy loads on the spine in patients with poor posture.
Symptoms of the disease
The manifestation and severity of symptoms of osteochondrosis depend on the stage of the disease.
There are 4 stages of the disease:
- The first stage is characterized by the appearance of pain in the lumbar region (lumbago), spasms of the surrounding muscle tissue and swelling in the affected area. During this period, a change and displacement of the nucleus pulposus of the intervertebral discs begins, which causes irritation of the nerve endings.
- In the second stage, the process of destruction of the fibrous rings of the intervertebral discs begins. The vertebrae become unstable, their mobility increases, which leads to constant tension of neighboring muscles. Pain is noted along the sciatic nerve. At this stage of the disease, disturbances in the work of internal organs can sometimes begin.
- In the third step, the fibrous rings rupture and the contents of the nucleus pulposus are released. As a result, herniated discs are formed. All this contributes to further deformation of the spine (the development of scoliosis, kyphosis or lordosis can be observed). Sharp pains become permanent, this is due to radicular syndrome, in which the nerve roots are squeezed by fragments that have fallen from the fibrous rings.
- The fourth stage is characterized by severe deformations of the spine, pathological growths appear on the vertebrae. There may be significant pain relief, but that does not mean improvement in the patient's condition. On the contrary, a person's movements become severely restricted. Usually, patients with stage 4 osteochondrosis require a disability registration.
One of the main symptoms of the disease is pain in the lower back, which can also spread to the tailbone and lower limbs. It is divided into 3 types:
- Lumbago- attacks of sharp pain that begin with sudden movements or lifting heavy objects.
- Lumbodynia- severe regular pain associated with damage to intervertebral cartilage and muscle fibers.
- Lumboishalgia- characterized by a sensation of pain, a feeling of cold or heat in the lumbar region, as well as in the legs.
A person's psychological state can also cause pain.
Besides pain, osteochondrosis is characterized by:
- feeling of weakness in the lower half of the body and in the legs;
- deterioration of tendon reflexes in the lower limbs;
- tingling, which may be felt from the lower back to the foot;
- curvature of the spine;
- with lumbosacral osteochondrosis, there is often a failure in the functioning of the pelvic organs (urination disorder, fecal incontinence, erectile dysfunction);
- skin problems (dryness, peeling, bluish tinge) and changes in sweating may also occur in the lower back and buttocks.
If you find the symptoms listed, you should see a doctor as soon as possible in order to start treatment quickly and to avoid serious consequences.
Treatment of osteochondrosis of the lumbar and lumbosacral spine
Medical
For a patient diagnosed with osteochondrosis, the doctor may prescribe the following types of therapy (several at once):
- drug treatment
- ;
- physiotherapy procedures;
- medical massage and manual therapy;
- perform surgery.
Let's take a closer look at each of these methods.
Medicines are prescribed to relieve pain, fight inflammation, and improve regeneration of diseased tissue. The patient can be assigned:
- analgesics
- (help relieve pain);
- muscle relaxants (used to relax muscle fibers and relieve spasms);
- chondroprotectors (promote the regeneration of cartilage and bone tissue and protect them from negative influences);
- anti-inflammatory drugs;
- in case of edema, diuretics (diuretics) are prescribed;
- medicines which improve blood circulation;
- vitamin and mineral complexes.
With common forms of osteochondrosis, when conventional pain relievers are ineffective, blockages may be prescribed. What specific drugs to use, as well as the scheme and duration of treatment, are determined by the doctor, taking into account the stage of the disease and the severity of the symptoms.
It is advisable to prescribe physiotherapy with drugs to increase the effectiveness of treatment. With osteochondrosis, the following procedures are indicated:
- laser therapy
- ;
- magnetic resonance therapy;
- phonophoresis; Shock wave therapy
- .
These treatments help relieve pain, reduce inflammation and repair damaged tissue. The use of a laser beam is very effective, it allows you to achieve stable remission.
When prescribing phonophoresis, additional topical drugs are used (this method allows the drug to penetrate deep under the skin directly to the lesion). To maximize tissue enrichment with oxygen, the doctor may also prescribe ozone therapy.
It should be borne in mind that physiotherapy is contraindicated in certain pathologies. It should not be prescribed to patients with oncological diseases, thyrotoxicosis, diabetes, tuberculosis, infectious diseases.
Massage and manual therapy can be prescribed simultaneously with drugs and physiotherapy procedures, which enhances the therapeutic effect.
These methods affect the conduction of nerve impulses and help normalize muscle tone.
Surgical intervention is indicated only in the later stages of the disease, when other methods of treatment are unnecessary. Surgery is necessary if:
- the patient is in severe pain which cannot be controlled with medication;
- a herniated disc has been detected;
- the patient is diagnosed with spinal cord compression (this leads to impaired sensitivity and motor functions - from feeling weak to paralysis);
- the development of cauda equina syndrome is noted.
Nowadays modern high-tech and low-trauma operations are performed more and more often, which can significantly shorten the rehabilitation period. In the absence of complications, the patient will be able to move around normally a few months after surgery.
Folk remedies
Traditional medicine treatments help relieve pain, reduce inflammation and improve mobility. Here are several ways to treat osteochondrosis with folk remedies.
- You have to take raw potatoes, grate them and mix them with natural honey. The resulting mixture should be placed on your back and secured with a bandage for at least 2 hours. Applying hot boiled potatoes to the affected area also helps.
- Grate the garlic and mix equally with the ginger. Then add olive oil. The resulting drug should be rubbed into the back at night to improve blood circulation and reduce muscle tension.
- Mix a spoonful of menthol oil with a spoonful of fir oil. The mixture should be rubbed on the back.
- Take chopped pine or spruce needles at the rate of ½ tablespoon per 200 ml (1 glass) of boiling water and let steep for 30 minutes. Drink ½ glass twice a day.
- Mix a tablespoon of lingonberries and mint herbs, boil with boiling water (1 glass), allow to infuse and filter. Drink the broth gradually throughout the day.
It is important to understand that treatment with folk remedies cannot replace a visit to a doctor. Traditional methods temporarily relieve symptoms, but they do not completely eliminate the disease.
Additionally, they may not be suitable for all patients, so it is strongly recommended that you consult a specialist before using them.
Physiotherapy exercises
Physiotherapy exercises aim to strengthen the muscles in the lower back, buttocks and thighs, which helps relieve pain, reduce the degree of pinching of nerves and blood vessels, and restore flexibility.
In order for the exercises to be as effective as possible and not cause any damage, certain guidelines should be followed:
- Exercises should be performed in clothes made of natural fabric that do not restrict movement;
- the lumbar region during physical education should not be hypothermic;
- if you have to take a lying position to perform the exercise, it is better to put a round roller under the leg;
- you should start exercising no earlier than one hour after eating;
- in order to achieve a lasting positive effect, it is necessary to regularly practice physiotherapy exercises; The
- exercises should be done smoothly, slowly, focusing on muscle work;
- you must watch your breathing, it must be regular and deep;
- It is helpful to keep a journal that includes the changes since the day you start the exercises.
The exercises to be performed depend on the severity of the symptoms of osteochondrosis.
In acute lumbar osteochondrosis, the spine should not be loaded, you should adhere to bed rest (preferably using an orthopedic mattress), and you can do physical education lying on your back, repeating each movement 8 to 10 times. Here are some suggestions:
- Lying on your back, place a roller under your shins and bend your knees. The patient should fold his arms into a fist and bend, and should also bend the legs at the ankle. These movements are done alternately with each arm and each leg.
- You should alternately bend and unfold your legs, moving only your knees. At the same time, the back should not move.
- Rotate each foot in turn.
- Extend your arms and legs, then start bending and extending the elbows of both arms at the same time. During flexion you should breathe in, and during extension exhale. Keep your hands palms up.
Recommended exercises for subacute lumbar osteochondrosis:
- With your knees bent in the supine position, put your feet on the mattress. While inhaling, gently lift the sacrum, while the lower part of the thoracic spine should rest on the mattress. After 1 to 2 seconds, gently lower the lower half of the back.
- Lying on a mattress, while inhaling, you should lift your head and tighten your abdominal muscles. When exhaling, return to the starting position.
- In the supine position, pull the heel towards the buttocks in a sliding motion, without lifting it off the mattress. After a few seconds straighten your leg. The movements should be repeated for each leg separately and for both legs at the same time.
- From a position on all fours, sit with your buttocks on your heels, making sliding movements with your hands on the mattress. Then take the starting position.
- Get on all fours, relax your neck. Squeeze your chin to your chest, bend your back in the lower back like a cat, fix this position for a few seconds. It is necessary to ensure that the head does not rise and the back maintains its accepted position.
Patients who have achieved remission can do any of the above exercises.
Physiotherapy exercises, if possible, should be done 3-4 times a day for any form of lumbar osteochondrosis, but before you start doing them, you should definitely consult a doctor.
Preventive measures
Osteochondrosis, like most other conditions, is much easier to prevent than trying to get rid of its consequences later. To minimize the likelihood of developing the disease, it is recommended:
- to ensure a healthy and balanced diet;
- lead an active life, move as much as possible;
- do not subject the spine to excessively heavy loads;
- Exercise to strengthen your back muscles.
It is also necessary to promptly treat diseases and injuries that can lead to the development of osteochondrosis. If even minor symptoms appear that may signal spinal problems, you should not delay the visit to the doctor.
Conclusion
Osteochondrosis of the lumbar spine is a disease that must be taken as seriously as possible in order to avoid serious consequences. If you adhere to a healthy lifestyle and follow the recommended preventive measures, the likelihood of developing pathology will be minimal.
If symptoms of the disease appear, you should see a doctor as soon as possible. Timely medical care is the key to stable remission, which allows you to stop the pathological process, preserve the patient's ability to work, and to a certain extent restore the previous state of the musculoskeletal system.