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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 deformation of the cartilaginous 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 occur in the vertebral tissues, they begin to gradually decay. If the mostly affected vertebrae are located in the lumbar region, osteochondrosis of the lumbar spine is diagnosed.

Clinical presentation

With osteochondrosis, the cartilaginous tissue of the vertebrae begins to lose moisture, the elasticity of the intervertebral discs deterioratesOver time, the height between the vertebrae decreases. Under increased load, the annular fibrosus begins to burst, the intervertebral disc comes out.This leads to pinching of nerve endings and pain.

In the absence of adequate treatment, osteochondrosis progresses. The intervertebral discs harden and the cushioning properties deteriorate. The growths form on the bone tissue of the vertebrae, which press on the nerve endings. As a result, patients develop constant pain.

Degrees and Classification

Specialists distinguish 4 degrees of spinal osteochondrosis:

  1. The process of destruction of intervertebral discs begins, the symptoms of the disease are mild, a burning sensation, tingling, pain occurs only after physical exertion. Patients report dull back pain, sometimes radiating to the buttocks.
  2. The distance between the vertebrae gradually decreases and the annular fibrosus begins to collapse. The intervertebral discs are compressed, crossing physiological boundaries, and pressure is applied to the nerve roots. Patients complain of palpable pain in the buttocks, thighs and legs. In addition to pain, tingling, cold is also possible.
  3. Fibrous rings are destroyed, intervertebral hernias are detected in patients during the examination. Pain constantly bothers me, no matter the load.
  4. The bony outgrowths of the vertebrae are visible. The cartilage atrophies, making it 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:
  • repetitive;
  • chronic;
  • chronically relapsing.
  • decreased (with exacerbations, clinical manifestations of the disease decrease);
  • progressive (progressive);
  • non-progressive.

Experts distinguish the following period of osteochondrosis:

  • debut;
  • deterioration;
  • remission;
  • stabilization.

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

ICD 10 code

According to the International Classification of Diseases, spinal osteochondrosis has been assigned the code M42. There are juvenile (M42. 0), adult (M42. 1) and unspecified (M42. 9) osteochondrosisseparately.

Prevalence and significance

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

Most often people over the age of 30suffer from lumbar osteochondrosis. Although it can be found in younger patients. Nearly 80% of patients who come to doctors with complaints of pain in the lumbar region are diagnosed with osteochondrosis.

Examination of patients older than 40 years revealed that most of them have characteristic changes on the intervertebral discs. But in the absence of clinical manifestations, the person is not considered ill.

In the absence of adequate therapy, the disease progresses. In neglected forms, it leads to the patient's disability.

Risk factors and causes

Representatives of such professions often encounter osteochondrosis: developers, office workers, builders, loaders, waiters and drivers.

Prolonged stay in an uncomfortable position is a risk factor for the development of lumbar osteochondrosis

Risk factors, in the presence of which the probability of developing osteochondrosis increases, include:

  • overweight;
  • unhealthy diet;
  • posture problems;
  • genetic predisposition;
  • lack of sleep;
  • frequent stress;
  • constant hypothermia;
  • must be in an awkward position for a long time;
  • low physical activity.

Reasons for developing osteochondrosis of the lumbar spine include:

  • natural aging processes of the body;
  • metabolic problems;
  • back injuries;
  • back problems;
  • flat feet;
  • intense physical activities, 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 tendency to develop osteochondrosis is transmitted at the genetic level.

Consequences

A change in the cartilage tissue located between the vertebraeleads to worsening of the annular fibrosus and the appearance of a hernia. Patients begin to complain of severe pain in the lumbar region that 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.

With osteochondrosissciatica(inflammation of the sciatic nerve) can develop. The disease leads to severe pain, numbness of the lower back, legs. Patients begin to walk, leaning to one side. This provokes further curvature of the spine and further destruction of the intervertebral discs.

Osteochondrosis causes instability of the spine. The lumbar region, under the influence of body weight, begins to move from the sacrum. In women, such instability causes problems with internal organs (uterus, ovaries, appendages), and in men - with potency.

When the intervertebral discs are destroyed, the blood flow to the spinal cord is obstructed, the movement of the vertebrae leads to compression myelopathy.

Cauda equina syndrome is considered to be the most dangerous complication. It lies in the fact that the nerve roots are affected. In severe cases, osteochondrosis causes paresis of the lower extremities 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 neglect the need for treatment.

Symptoms

Osteochondrosis does not appear immediately. In the initial stages, the patient has no pain or discomfort. Complaints usually occur when the disease progresses to stage 2.

The main symptoms of lumbar osteochondrosis include:

  • lumbar pain that worsens as the disease progresses;
  • impaired mobility: problems occur when trying to bend, turn, feelings when changing body position patients describe as "electric shock", pain in many of them radiates to the leg;
  • change in limb sensitivity, which appeared in the background of nerve root damage, burning, numbness, crawling, crawling, tingling are felt in the affected area;
  • muscle weakness, lack of tendon reflexes;
  • local temperature drop;
  • increased sweating;
  • pallor, dry skin on problem area;
  • urination disorders, sexual dysfunction (in severe osteochondrosis).

Some patients have spasm of arteries in their legs. But the symptoms are expressed only in the acute form of osteochondrosis. Worsening can begin suddenly with hypothermia, uncomfortable movements or after intense physical activity.

Which doctor treats?

If you have lower back pain, you shouldvisit an orthopedist and neurologist. The examination assesses the patient's neurological condition, checks how the spine performs its functions. Doctors also assess the condition of the back and gluteal muscles.

For experienced specialists, one examination is enough to establish a preliminary diagnosis. But to confirm that, the patient is sent for hardware diagnostics.

Diagnostic Methods

The simplest and most affordable method for detecting osteochondrosis isradiography. But in order to get a more accurate image, a computer image or magnetic resonance imaging is prescribed.

MRIenables the most accurate examination of the condition of the spine. In fact, during the procedure, layers by layers of the problem area are painted.

Treatment

Physiotherapy for the treatment of lumbar osteochondrosis

The tactics of therapy are chosen by the doctor depending on the patient's condition, stage of osteochondrosis and clinical manifestations of the disease.

Your doctor may prescribe:

  • drug therapy, non-steroidal anti-inflammatory drugs, hormonal drugs, analgesics were selected;
  • drug blockade, analgesics, hormonal drugs are injected into the affected area or muscles located around the problematic spine, which almost instantly relieve inflammation and eliminate pain;
  • manual therapy, massage, physiotherapy, recommended after stopping the acute stage of the disease, with the help of physiotherapy you can improve the effectiveness of drug treatment;
  • medical gymnastics;
  • acupuncture.

Advanced surgery required. Surgical intervention is prescribed in situations when conservative treatment does not bring the expected results.

Conclusion

The progression ofdystrophic-degenerative changes in the cartilaginous tissue of the lumbar spine diagnoses osteochondrosis. In advanced forms, this disease can lead not only to the appearance of constant severe pain, but also cause paresis, paralysis of the lower extremities.

  • You may suspect the development of osteochondrosis by lower back pain. As the disease progresses, the pain increases significantly, and the lower back loses mobility.
  • Depending on the degree of destruction of the intervertebral discs, there are 4 stages of the disease.
  • This diagnosis is more common in people over the age of 30. Nearly 80% of patients who go to the doctor for back pain are diagnosed with osteochondrosis.
  • Those people who lead an inactive lifestyle are prone to osteochondrosis, have been in an unnatural position for a long time and have frequent physical overload.
  • The main symptoms of osteochondrosis are pain and impaired lower back mobility.
  • Due to the destruction of the intervertebral discs in the lumbar spine, patients develop problems with their legs.
  • If left untreated, pain increases,sciatica, vertebral instability, compression myelopathymay develop. 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, blockades, massage, manual therapy, physiotherapy, exercise or surgery.