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One of the most common forms of osteochondrosis is osteochondrosis in the lower back, or, more precisely, the lumbosacra spine.For a lot - men and women - are familiar with back pain in the lower back, sacred, lower ends, caused by various types of lumbar osteochondrosis and their complications.Among the reasons for disability and temporary disability, this disease occupies one of the first places.
The course of the disease is chronic, usually with periods of exacerbations.Most of the time, exacerbations of osteochondrosis of the lumbar lumbar elevator and weight transfer, hypothermia, stress and injury are caused.
Lumbar spine osteochondrosis - causes, mechanism of occurrence and development
There was no unequivocal cause of osteochondrosis, the disease is considered polyfaver.The Most Popular Theory is, according to which the cause of osteochondrosis of the spine is the constant overwhelming of the muscles or hypototension of muscles, nonphysiological muscle tension, whiche leads to overloading the vertebral segments, the deterioration of their blood supply and supply,Ultimately, to the degeneration of the intervertebral discs and joints, the result of which is the result of which the result osteochondrosis.
The cause of premature aging of intervertebral discs can also be endocrine and metabolic disorders, a hereditary predisposition to the development of osteochondrosis, autoimmune disorders and microtrauma.The negative role of the visceral was also proven, that is, related to internal organs, pathologies in the development of spine osteochondrosis.A significant role in the development of the disease belongs to adverse heredity.The contribution of hereditary factors to the onset of lumbar osteochondrosis is about 60%, the rest refers to the adverse external influence factors in the spine.
The factors that contribute to the development of osteochondrosis in both lumbar and other parts of the spine are very numerous.The main one: inadequate posture, hypodinâmia, muscle overlapping in the lower back as a result of the constant use of weights or a clear excessive load, hormonal restructuring, endocrine and somatic diseases, violation of the normal blood supply to the tissue of the spine, emotional stress, age -related changes, poor nutrition.Under the influence of these factors on the spine structures, the processes of dehydration and circulatory disorders, arthrosis and subluxation in small joints, bone growth and hernies are increasing gradually.
The most obvious causes of lumbar osteochondrosis are most often considered a sedentary lifestyle and back injury.Therefore, the risk group mainly includes people whose profession is directly related to back loads.This is a wide range of professions - salesman and waiters, surgeons and teachers - all who are forced to spend most of their working time.The risk group includes builders and engines, as well as athletes who, in the nature of the activity, appear large loads in the spine.In addition, drivers, several office workers, programmers - that is, those who have their work mainly sedentary and who suffer from hypodinamia, suffer from lumbar osteochondrosis.
Symptoms of lumbar spine osteochondrosis
Nodelumbar osteochondrosisPainful sensations of various nature are possible.This can be painful pain that occurs with a prolonged seat or after sleep, and triggered accentuated, causing the most uncomfortable pose and not allowing the opportunity to straighten.The pain is compressed by the nerve roots, the irritation of the spinal spine nerves themselves, edema and irritation of the muscles and ligaments located in the lumbar spine innervation zone.
Pain syndrome can be caused by the compression of radietmic structures (radiculopathy), spinal cord compression (compression myelopathy), spinal cord damage due to the harmed blood supply due to the intensifier, narrowing (stenosis) of the artery and compression veins (myolhemia).
The reason for compression can be: protrusion and hernia of intervertebral discs, spondylolistz (sliding the vertebra forward in relation to the underlying), the growth of osteophytes and cartilaginous tissue in the vertebral segment.As a resultLumbar osteochondrosisThe spine leads to a narrowing of the canal through which the cerebrospinal nerves or vascular structures pass and, under certain conditions (strange movement, physical activity, an unsuccessful turn of the body, etc.), compression (tightening) may occur.Compression of nerve structures leads to various pain syndromes, muscle spasms.Compression of blood vessels causes a violation of blood supply - the ischemia of the organ that feeds on this vessel or the artery begins.
Clinical syndromes of lumbar spine osteochondrosis
The clinical picture of lumbar osteochondrosis is determined by a vertebral symptom complex (a change in lumbar spine static and dynamics) and escorted symptoms, which are understood as a violation of the function of neurological and vascular structures in the lumbosacral spine region.
Vertebral syndromes of osteochondrosis lumbar
With lumbar osteochondrosis, vertebral syndrome is characterized by the following symptom complex:
- In violation of the configuration of the functional anatomical segment of the spine: a flattened increase or (less frequently) is observed lordosis, scoliosis or lordoscoliosis;
- Violation of mobility in the lower back, a decrease in the volume of movements, the muscle-tenonic imbalance caused by the tension of the deep and superficial multi-human muscles;
- Local pain and pain with active and passive movements, which causes reflective tonic muscle tension;
- In violation of intervertebral disk spring motor functions and, in general, from the vertebral motors segment;
- LOCAL DONORITY (Increased sensitivity) of bone ligaments of the spine in the affected area (pain during palpation, local pain syndrome (regional) and/or vertebrous).
It is important to note that with the osteochondrosis of the Lumbar Department, vertebral pathologies are always observed.The presence of signs of myelopathy, radiculopathy and myeloradiculopathy without obvious clinical and morphological signs of vertebral syndrome requires, as a rule, a further patient examination for primary damage ("non -solo") to the nervous system.
Extrovert syndromes (reflex and compression) for lumbar spine osteochondrosis
Extrovertebral syndromes are divided into two large groups: reflex and compression.
Reflex syndromesThey precede compression and are caused by irritation of nerve root receptors emerging from the spinal canal through intervertebral holes.Irritation can be caused by intervertebral hernia, bone growth as well as vascular disorders (edema, worsening blood circulation) and inflammation.In some cases, this leads to intensive pain, which occurs not only locally, but also in the course of the nerve at a distance from the irritation site -the “reflected pain” of the same ice, reflected pain can be short and acute (“change”) or long -term stupid.In the damaged nerve innervation zone, vegetative disorders (burning, chills, impaired sensitivity) are possible.Possible myofascial pain - muscle spasm, which leads to limiting movements.
Reflection syndromes include lumbago ("shift") in acute development of disease and lumbalgia with subacute or chronic course.
Compression syndromes are syndromes that occur as a result of compression, nerve violation, blood vessels, spinal cord in the area of lumbar spinal segments.Compression syndromes for osteochondrosis of the Lombsacro department are divided into radular and vascular brown.A special case of compression syndrome is myelopathy - violation of the spinal cord.
Remedy syndromes (radiculopathy) are usually due to discloses of the disc, causing violation of cephalorean roots.The root symptoms that arise in this case correspond to the affected vertebral segment level.Most of the time, L4-S1 roots are affected.
Brown-vascular neurological disorders are caused by the compression of hernia in the spine and the root artery that passes through it.At the same time, “paralytic ishias” can develop catastrophically, characterized by peripheral paresis or paralysis of the extenders of the foot.In such cases, the onset of motor disorders is accompanied by the disappearance of pain.
Even more severe neurological manifestations are caused by a violation of blood supply in the spinal cord due to damage to root spinal arteries.At the same time, the chronic myelopathy of the devoids develops, usually at the level of the lumbar thickening of the spinal cord.
The most unfavorable version of lumbar vertical root syndromes is the compression of the “horse tail” - the so -chall's caudal syndrome.Most of the time, it is caused by the disk falling medical hernia, which squeezes all the roots at the affected segment level.
What is lumbar spine osteochondrosis?What are your symptoms?How to treat lumbar osteochondrosis?
Clinical classification of osteochondrosis of the lumbar region.Degree of osteochondrosis
The classification of lumbar osteochondrosis according to the degrees is used for the systematic characteristics of the clinical manifestations of the disease.This classification systematically describes the symptoms of the disease and begins from the moment the patient has pain.
1 degree of osteochondrosis
It occurs when the intervertebral disc caused by a clear movement or overtension occurs.It is manifested by a sudden pain;In the spine, a sense of passage from electric current arises, the muscles are reflectively tense.
2 degree of osteochondrosis
The second degree may manifest in the form of intervertebral protrusion symptoms and spine instability.Chronic pain increasing in loads.The intervals of remission and exacerbations alternate.The cervical region is characterized by neck pain, increasing after a long stay in a position, headaches, hand pain, shoulder pain, periodic discomfort or numbness on the fingers.For the lower back - lumbar pain, pain in the gluteal region, periodic pain in the sacred, frequent leg fatigue.
3 degree of osteochondrosis
It Manifests Itself in the form of sympts of the Hernia of the Intervertebral Disc (pain along the affected nerve, numbness of the arms or legs, the Change in Gait, Headaches) or distance symptoms of the intervertebral hernia (in the cervical spine: frequent headaches, noise in the ears,DECREAZINES, DECREASE IN VISION, MUSCLE STRENGTH IN THE HANDS OF THE THORACIC: VIOLATION OF THE CORDIAL REGION: BREEDING RITE, DIFFICULTY TO BREATH: Renal Disease, Gastrointestinal Treatment, Genital Area Violations, Numbness, or Free Weakness).
4 degree of osteochondrosis
It is generally accepted that the fourth degree of osteochondrosis begins from the moment the hernia no longer manifests, manifestations of the disease may decrease, but the symptoms of spine instability, slipping or cheering the vertebrae, or their full fixation is still relative.The manifestations of the growth of vertebral bodies (osteophytes) can join them, which can also squeeze the spinal nerves or overlap the spinal canal (secondary spinal canal stenosis) and squeeze the spinal cord (spinal cord ischemia).In addition, the fourth degree includes the consequences of surgical intervention if hernia was promptly removed (various types of innervation, paresis, inflammation).
Treatment of lumbar spine osteochondrosis
With the first acute pain in the lower back, it is necessary to consult a doctor to establish a diagnosis in order to exclude a renal colic, appendicitis or any other disease that requires emergency care.
If the cause of back pain is known and this exacerbation of lumbar spine osteochondrosis first and foremost must maximize the load in the spine.It is necessary to observe bed rest for 3 to 7 days - sometimes only this can significantly reduce pain.But in order to accelerate recovery, it is necessary to be effective treatment.It must stimulate their own processes of protection and health in the human body.Treatment should take into account the location of the lesion, the stage of the disease, the functional state of the body and its individual systems.The surgical treatment of this disease is indicated only in very severe cases.Most of the time, various conservative osteochondrosis treatment methods are used.
Conservative treatment of lumbar osteochondrosis
Conservative treatment methods are first and foremost drug treatment.To reduce pain, as well as reduce inflammation, which is usually the cause of vertebral syndrome, non -steroid anti -inflammatory drugs (NSAIDs) in the form of tablets or - in acute cases - in the form of injections are prescribed.Sometimes, after injection, an painkiller, pain calms and is not resumed even when the duration of the medicinal substance ends.This means that it was possible to break the vicious circle in which pain leads to muscle cramps and muscle tension, in turn, increases pain.However, if the pain lasts a long time, it is important to remember that NSAIDs usually have several side effects and with prolonged use can cause unwanted complications - a decrease in the number of blood leukocytes, gastrointestinal tract complications.
Frequently, sedative agents (soothing) are prescribed to improve the general condition of patients within 1 to 3 weeks, as well as small doses of antidepressants.With lumbar spine osteochondrosis, if necessary, the blockade of the novocaine is produced.Recently, anticonvulsant drugs have begun to be used successfully to relieve pain.
To reduce compression syndromes, manual therapy, traction treatment (spine traction) and special cases - surgery are used.
When weakening the fixation properties of the ligament apparatus and consistency of the spine, it is recommended to use fixing devices - scorers, necklaces, dressings, etc.However, only limited time can be used fixing devices, because when used, weakening of the muscles is observed.And patients with spinal osteochondrosis are extremely important in the future to strengthen their own muscle corset.
After removing acute symptoms, the task of creating muscle fixation comes first and then stimulating the regeneration processes of damaged structures.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use chondroprotectors (medicines to restore cartilage tissue).As well as medicines that improve the condition of blood vessels (angioprotectors), vitamins, especially group B, calcium preparations that improve the condition of bone tissue.
For the treatment of spine osteochondrosis, physiotherapeutic procedures are widely used.They reduce tissue pain and edema, improve blood circulation and stimulate muscle fixation.The procedures can be combined, alternative.Such methods of physiotherapeutic treatment such as:
- Darsonvalization of the affected area of the rear and affected limbs;
- electrophoresis;
- Low -energy laser radiation;
- Ultrasound;
- exposure to the magnetic field;
- Thermal procedures.
Under the conditions of the sanatorium, mud, ozioceritic, paraffin applications, radon, sulfide, hydrogen sulfide, terebintina and other baths are successfully used;
It should be remembered that, for the development of total regeneration, it takes a very long period of time, in favorable circumstances that occurs in the sixth month.Therefore, treatment should be long.It should be done combined, ie medications combined with physical therapy and physical therapy exercises.