Probably, it is impossible to find a single adult who does not know what "lumbar osteochondrosis" is.On average, one in three healthy, middle-aged and sometimes more often experienced an episode of acute back pain in their life, and one in five or six indicates that such problems arise regularly and are even a "source" of sick leave.
However, patients are often unable to explain in detail what disorder is occurring in the lower back.Most of them have never been examined, and treatment consisting of 'needle', 'ointment' and massage sessions usually helps for a few months to a year.
If you "push" such a patient and start asking him about the diagnosis, after a little suffering he will declare that he has "osteochondrosis".What does this disease mean in relation to the lower back?
Osteochondrosis of the lumbar region - disease or "normal life"?
First of all, we must state with authority: "osteochondrosis" cannot harm.And this cannot manifest itself in any way, because it is the process of dystrophy and degeneration of intervertebral discs, that is, cartilage consisting of a pulpous nucleus and a fibrous ring.The intervertebral disc is cartilage and is designed to act as a shock-absorbing "airbag" that creates a brake between adjacent vertebrae, dampening vertical and angular accelerations.
As it is known, the cartilage is devoid of nerve and vascular tissue, so the processes occurring in "pure discs" simply cannot affect the neighboring structures and do not manifest themselves in any way.A similar example in vertebroneurology is Schmorl's hernia, in which the hernial protrusion is securely covered by the bone tissue of the adjacent vertebra.Intervertebral discs do not hurt.
Chondrosis (the suffix "-oz" means growth, growth) is completely incorrect in this case.There is no growth or growth in cartilage tissue during human life.With fibrosis (cirrhosis) of the liver, you may notice that the mesh structure of the liver begins to develop, impairing function.
And with chondrosis (or osteochondrosis), the intervertebral discs begin to change their configuration only under the influence of many years of stress.
They put pressure on the neighboring vertebrae, because according to Newton's law, every movement under a static load causes the same reaction or support reaction.How does osteochondrosis develop and what causes it?
Causes of lumbar osteochondrosis
Symptoms of lumbar osteochondrosis (more precisely, intervertebral discs) can be detected at a young age, especially with various disorders of the musculoskeletal system.
These include, for example:
- congenital anomalies (different leg lengths);
- different types of straight legs (longitudinal, transverse);
- deformations of the spine (scoliosis);
- spondylolisthesis (slippage of the lower lumbar vertebra from the sacrum both forward and backward).
All these diseases can cause either an increase in the impact load on the spine (for example, with flat feet, when the flexibility of the arch of the foot is reduced) or with an open asymmetry of the spine when the supporting function is systematically performed due to the load on the edge of the disc.
It is known that during experiments, it was found that healthy and young cartilages can withstand up to 2000 kg and even higher loads without damaging themselves, if an equal and static load is applied along the entire surface.Of course, such a load does not exist in everyday life, but it can rise to such values when exposed to the edge of the disk.
If the support area is 20 times smaller and the disc is not so healthy (for example, in old age), then a 60-80 kg impact (for example, falling on the ice with a load on the shoulders while leaning on the side) can lead to the destruction of the disc, which can be in the form of a protrusion or tear.
It is the appearance of a protrusion or tear that indicates that the disc is deformed and even "pops out" on one or more sides.And as you know, there is no free space around the disk.As soon as the disc comes into contact with the nerve roots, neighboring ligaments and muscles, the results of osteochondrosis arise: reflex pains and muscle-tonic syndromes, forcing the patient to consult a neurologist, chiropractor and massage therapist.
If the discs have a normal shape and wear evenly without excessive load, lumbar osteochondrosis does not bother the patient as much as the normal age-related wear of the teeth, which is well known to criminologists.How do reflex pain syndromes manifest themselves?
Symptoms and signs of complex lumbar osteochondrosis
You have already seen that we are diligently "spreading" the bridges: ordinary osteochondrosis is an absolutely inevitable process of normal aging of the elastic intervertebral "cushions" in the "Homo sapiens" species, as it moves vertically throughout life."Osteochondrosis", as patients with acute pain remember, is a complex condition.
Let's start, perhaps, with the symptoms of radicular compression.Symptoms of lumbar osteochondrosis are, of course, associated with pain due to compression of the segmental nerve root by the disk.In addition to pain, sensory, motor and vegetative-trophic disorders are possible.
Back pain with osteochondrosis has the following characteristics:
1) Radicular pain.It is secondary and, like neuralgia, occurs when the swollen nerve root reacts too "violently" to the shock.
The pain is sharp, sudden, burning, stabbing in the lower back, perhaps spreading to the leg.The pain appears and immediately intensifies, which is why it is called "lumbago" or "lumbago".It is this kind of "lumbago" that forces a person to "get up in a hurry", because any movement causes an increase in pain.
In addition, the pain intensifies with the slightest cough, sneeze, tension, laughter - any situation in which the swollen root is shaken.
If the root is part of the sciatic nerve, the pain "shoots" through the hip to the popliteal fossa and down, and this is called "lumbar sciatica."
2) Muscle pain.There are large muscle masses near the nerve root.Often in spring and autumn, they "get cold" and become swollen and tight.They block venous flow and are themselves a source of pain.
This pain is painful, constant and not very sharp.On the contrary, it is intensified not only by sudden movement, but also by staying in a monotonous position for a long time (deterioration of blood supply).
- Sometimes such myofascial syndrome occurs when the sharp "hook" of the hernia "massages" the muscles and ligaments for a long time after the exacerbation of the protrusion or hernia.
3) Movement disorders.Since the disk can compress not only the sensory but also the motor root, the development of peripheral paresis or even paralysis is possible.At different levels of damage, weakness in the legs (for example, weakness when climbing stairs on one side), weakness in the leg leading to impaired gait may appear.
Muscle wasting occurs and one leg "goes thin".This type of purely motor, painless disorder is rare and can be disabling if ignored.
4) Sensory disorders.They occur with pain and are often present after the pain is gone, not during it.They manifest as numbness, reduced sensitivity of the skin of the legs in the form of "stripes", vertical stripes and a feeling of "creeping goose bumps" on the fingers and toes.
- Sometimes, when vegetative fibers are damaged, symptoms are combined with hyperhidrosis, cold skin, hair and nail growth disorders.
These are the most common symptoms of complex lumbar osteochondrosis present in the lumbar region.There are separate syndromes, such as external cutaneous nerve damage of the thigh or cauda equina damage, epiconus, pure radiculitis or piriformis syndrome - but even a brief description of them would take too long.
For patients, the above-mentioned main symptoms are enough to make an appointment with a neurologist.How can you alleviate the situation with your own hands?How to treat lumbar osteochondrosis at home?
What to do during exacerbation of lumbar osteochondrosis?
The basis of any treatment is etiotropic therapy (elimination of the cause) and pathogenetic treatment (effect on the mechanisms of the disease).It is accompanied by symptomatic therapy.
Things to do for vertebrogenic pain (caused by problems in the spine) are:
- The elimination of the cause is the removal of pressure from a nerve root protrusion, hernia, or spasmodic muscle;
- Effects on the mechanisms are elimination of muscle spasm, restoration of venous flow in muscles, elimination of nerve root swelling and fight against inflammation;
- Symptom relief (pain, numbness, limited mobility) is accomplished by returning to point 2, as removing swelling and inflammation, for example, will restore mobility and relieve pain.
Getting rid of protrusion and hernia
As a rule, it is not the starting point for the treatment of acute back pain.Almost always, the pain syndrome is relieved first, then after massage sessions and treatment by a chiropractor, all symptoms disappear and surgical intervention is not required.
The question of surgical intervention arises with the progression of weakness in the leg and severe, unbearable pain for 2 months.In addition, surgery is required if there is a high degree of compression of the central canal containing the spinal cord or cauda equina.
Treatment of lumbar osteochondrosis, drugs
Treatment of lumbar osteochondrosis and its complications includes the following measures.In the acute phase (the first day - two):
- A salt-free diet and limiting the amount of fluid consumed is indicated to reduce swelling of the muscles and spine.You can even give a mild potassium-sparing diuretic tablet.
- It is recommended to wear a semi-rigid orthopedic corset that protects the muscles from excessive movement.
- From the first days, it is recommended to rub on warming ointments containing NSAIDs and apply patches, for example, "pepper" patches.
- In the acute phase, you cannot warm your back.As inflammation increases, so does swelling.Therefore, any heating pads are prohibited.You can warm up by emitting your own heat (wool belt, warming ointments), which does not add it from the outside, but instead draws it out from deep inside.
- In the acute phase of lumbar osteochondrosis, short-term treatment can be carried out with intramuscular "injections" of NSAIDs and muscle relaxants.It will help to remove swelling of nervous tissue, remove inflammation and normalize muscle tone.
In the subacute period, after maximum pain relief, no more "needles" should be taken and attention should be paid to restorative substances, for example, modern vitamin preparations of the "B" group.They effectively restore impaired sensitivity, reduce numbness and paresthesia.
Physiotherapy measures continue, it's time for exercise therapy for osteochondrosis of the back.Its task is to normalize blood circulation and muscle tone, when swelling and inflammation have already decreased, but muscle spasm has not yet been completely resolved.
Exercises for lumbar osteochondrosis of the spine should be performed on "warmed muscles" after a light general warm-up.
The main therapeutic factor is the movement, not the degree of muscle contraction.Therefore, the use of weights to prevent relapse is not allowed;a gymnastic mat and a gymnastic bar are used.With their help, you can effectively restore the range of motion.
Applying to ointments and using the Kuznetsov implicator continues.Swimming, underwater massage, Charcot shower are indicated.It is at the stage of exacerbation of extinction that drugs for magnetic therapy and physiotherapy are indicated at home.
Usually, treatment does not take more than a week, but in some cases, osteochondrosis can manifest itself with such dangerous symptoms that surgical intervention may be necessary and urgent.
Complications of lumbar osteochondrosis of the spine
First of all, we are talking about a situation where the disc herniation becomes an independent fragment and penetrates the central canal, forming a free sequestration.There, it can compress the nerves of the cauda equina and suddenly (in the gym, after an episode of acute pain) severe weakness or paralysis of the legs, numbness of the perineum can develop.
After a few minutes, severe pain appears in the legs, and then reflex urination or the appearance of incontinence is possible, and impotence develops.This occurred as cauda equina syndrome as a complication of a herniated disc.In this case, urgent intervention is required, removing the sequestration and restoring the function of the cauda equina nerves by decompressing them.
But more often other complications arise.With age, numerous tears and protrusions appear, osteoporosis of the vertebrae appears, and mobility simply decreases significantly, and the risk of acute back pain increases.Such patients must "take sick leave" once or twice a year and are often treated in sanatoriums.
Treatment prognosis
Lumbar osteochondrosis, the symptoms and treatment of which we discussed above, as I understand it, in most cases is not a disease at all, but simply a manifestation of the inevitable aging and premature "shrinking" of the intervertebral discs.
Can humanity completely get rid of lumbar osteochondrosis?This answer can be answered in the affirmative, but then we will have to learn a different way of moving: walking on all fours all our lives, or swimming into the depths of the ocean like Ichthyander, constantly moving in water from childhood.It is then that the axial, static load on the intervertebral discs will disappear, and the signs of "chondrosis" will also disappear.But another problem will arise: such a strong structure in water will simply be unnecessary and will begin to change until it disappears or is significantly reduced.
As for the individual, individual prognosis for osteochondrosis, it all depends on when a person "decides to come to his senses".If by this time there is no obvious destruction of intervertebral discs, protrusions, tears and deformations, you may not have back problems until very old age, in accordance with a healthy lifestyle and hygiene of physical activity.
In the same case, if there is a "hot spot" in the lumbar region, for example, in the form of a hernia that periodically compresses the nerve root, then a person should be especially careful to avoid awkward turns, physical exertion, improper lifting of weights, and seasonal hypothermia, which usually lead to exacerbation of spinal osteochondrosis.