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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 while the vertebrae are strong.

If the condition worsens, the intervertebral discs lose elasticity and begin to dry out.

As a result, patients develop severe lumbar pain.

What is this?

When dystrophic-degenerative changes occur in the vertebral tissues, they begin to gradually collapse. If the vertebrae located in the lumbar region are mainly affected, then osteochondrosis of the lumbar spine is diagnosed.

Clinical presentation

In osteochondrosis, the cartilaginous tissue of the vertebrae begins to lose moisture, the elasticity of the intervertebral discs deteriorates. Over time, the height between the vertebrae decreases. With increasing load, the fibrous ring begins to crack, the intervertebral disc protrudes.This results in pinching of the nerve endings and pain.

In the absence of adequate treatment, osteochondrosis progresses. The intervertebral discs harden, their cushioning properties deteriorate. Protrusions form on the bone tissue of the vertebrae, which compresses the nerve endings. Therefore, patients develop constant pain.

Degrees and classification

Experts distinguish 4 degrees of spinal osteochondrosis:

  1. The process of destruction of the intervertebral discs begins, the symptoms of the disease are mild, a burning sensation, tingling, pain appears only after exercise. Patients talk about the appearance of dull back pain, sometimes they radiate to the buttocks.
  2. The distance between the vertebrae gradually decreases and the annular fibrosis begins to collapse. The intervertebral discs are compressed, go beyond physiological limits, there is pressure on the nerve roots. Patients complain of palpable pain, which in the process of walking is given to the buttocks, thighs and legs. In addition to pain, burning sensation, cold is possible.
  3. The fibrous rings are destroyed, intervertebral hernias are found in patients during the examination. The pain bothers me constantly, regardless of the load.
  4. Bone growths from 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 by the type of disease:
  • repetitive;
  • chronic;
  • chronically recurrent.
  • regression (during exacerbations the clinical manifestations of the disease decrease);
  • progressive (progressive);
  • non-progressive.

Experts distinguish the following period of osteochondrosis:

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

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

ICD 10 code

In accordance with the International Classification of Diseases of Spinal Osteochondrosis, code M42 has been assigned. Separately there is juvenile (M42. 0), adult (M42. 1) and unspecified (M42. 9) osteochondrosis.

Distribution and significance

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

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

A study of patients over the age of 40 revealed that most of them had characteristic changes in the intervertebral discs. But in the absence of clinical manifestations, a person is not considered ill.

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

Risk factors and causes

Often representatives of such professions face osteochondrosis: programmers, office workers, builders, loaders, waiters and drivers.

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

Risk factors that increase the likelihood of developing osteochondrosis include:

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

The reasons for the development of osteochondrosis of the lumbar spine include:

  • natural aging processes of the body;
  • metabolic problems;
  • back injuries;
  • back problems;
  • flatfoot;
  • intense physical activity, such as lifting weights;
  • 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 between the vertebraeleads to worsening of annular fibrosis and the appearance of a hernia. Patients begin to complain of severe pain in the lumbar region, which 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.

Osteochondrosismay develop sciatica(inflammation of the sciatic nerve). The disease leads to severe pain, tingling in the lower back, legs. Patients begin to walk, bent to one side. This provokes additional curvature of the spine and further destruction of the intervertebral discs.

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

When the intervertebral discs are destroyed, the blood supply to the spinal cord is disrupted, the displacement of the vertebrae leads to compression myelopathy.

Cauda equina syndrome is considered the most dangerous complication. It lies in the fact that the nerve roots are affected. In severe cases, osteochondrosis causes paresis of the lower limbs or paralysis of both legs.

It is possible to prevent the development of negative consequences if you consult a doctor at the first symptoms 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 appear when the disease progresses to stage 2.

The main symptoms of lumbar osteochondrosis include:

  • lumbar pain, which worsens as the disease progresses;
  • impaired mobility: problems occur when trying to bend over, turn around, the sensations of changing body position are described by patients as "electric shock", the pain in many of them radiates to the legs;
  • change in the sensitivity of the limbs, which appeared against the background of damage to the nerve roots, in the affected area there is a burning sensation, tingling, crawling, tingling;
  • muscle weakness, lack of tendon reflexes;
  • local temperature drop;
  • increased sweating;
  • pallor, dry skin in the problem area;
  • urination disorders, sexual dysfunction (with severe osteochondrosis).

Some patients have spasm of the arteries in their legs. But the symptoms are expressed only in the acute form of osteochondrosis. Exacerbation may begin suddenly with hypothermia, awkward movement or after intense physical activity.

Which doctor treats?

If you have 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 sufficient to establish a preliminary diagnosis. But to confirm it, the patient is sent for hardware diagnostics.

Diagnostic methods

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

MRImakes it possible to examine the condition of the spine as accurately as possible. In fact, layer photos of the problem area are taken during the procedure.

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.

The doctor may prescribe:

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

Operation required in advanced cases. Surgical intervention is prescribed in those situations when conservative treatment does not bring the expected results.

Conclusion

With the progression ofdystrophic-degenerative changes in the cartilaginous tissues of the lumbar spine, osteochondrosis is diagnosed. 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 through the appearance of lower back pain. As the disease progresses, the pain increases significantly, the lower back loses its 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. Almost 80% of patients who go to the doctor for back pain are diagnosed with osteochondrosis.
  • These people, who lead an inactive lifestyle, are prone to osteochondrosis, are unnatural for a long time, experience frequent physical exertion.
  • The main symptoms of osteochondrosis are pain and impaired mobility of the lower back.
  • Due to the destruction of the intervertebral discs in the lumbar spine, patients develop problems with their legs.
  • If left untreated, the pain increases,may develop sciatica, vertebral instability, compression myelopathyIn advanced cases, paralyzes the lower extremities.
  • In case of painit is necessary to consult a neurologist and orthopedist. The patient is sent for an X-ray, computed tomography or magnetic resonance imaging.
  • Depending on the condition of, medications, blockades, massage, manual therapy, physiotherapy, physiotherapy exercises or surgeryare prescribed.