Osteochondrosis is the most severe form of degenerative spine -dystrophic damage, based on the pulp nucleus of the intervertebral disc, with further deformations of the surrounding spine, including the intertebral joints, and the nervous system.
One of the most common forms of osteochondrosis is osteochondrosis of the lumbar region, or, more precisely, the lumbar spine.Many - both women and men - are well aware of the spinal pain in the lower back, in the sac, in the lower extremities, which are caused by different types of lumbar osteochondrosis and its complications.Among the causes of temporary disability and disability, this disease ranks one of the first.
The course of the disease is chronic, usually with periods of exacerbation.Most often, lumbar linen elevator osteochondrosis exacerbations and weight, hypothermia, stress and damage are transmitted.
Lumbar spine osteochondrosis - Causes, Mechanism of Events and Development
There was no unambiguous cause of osteochondrosis, the disease is considered polyphovic.The most popular theory is that the cause of osteochondrosis of the spine is constant muscle excessive or muscle hypotension, non -muscle tension, which causes overload of spine segments, deterioration of their blood supply, and finally the result of interestertic osteochondrosis.
Premature aging of intervertebral discs can also be caused by endocrine and metabolic disorders, hereditary predisposition to the development of osteochondrosis, autoimmune disorders and microtrauma.The visceral negative role is also confirmed, that is, the internal organs, pathologies in the development of osteochondrosis of the spine.An important role in the development of the disease is a negative heritage.Hereditary factors contribute to the appearance of lumbar osteochondrosis about 60%, the rest relates to negative effects on the spine.
Factors that contribute to the development of osteochondrosis, both in the waist and in other parts of the spine, are very numerous.Their main: inadequate posture, hypodynamics, excessive muscle excessive lumbar region, permanent weight or sharp excessive loading, hormonal restructuring, endocrine and somatic diseases, normal blood tissue, emotional stress, age -related changes.In the spine structures, under the influence of these factors, the processes of dehydration and circulatory disorders, arthrosis and sublux in small joints, bone growth and discs - hernia gradually increases.
The most obvious causes of lumbar osteochondrosis are most commonly considered seductive lifestyle and spinal injury.Thus, the risk group primarily includes people whose profession is directly related to the back of the load.This is a very wide range of professions - seller and waiters, surgeons and teachers - all who are forced to spend most of their work time.The risk group includes builders and movements, as well as athletes who, by the nature of the activity, produce large loads of spine.In addition, drivers, various office workers, programmers - that is, those who have work are mainly tempting and who suffer from hypodynamics, suffer from lumbar osteochondrosis.
Symptoms of osteochondrosis of the lumbar spine
UpLumbar osteochondrosisPainful sensations of different nature are possible.It can be or painful pain that is found in a prolonged chair or after sleep, as well as a sharp shoot, which causes the most unpleasant posture and does not allow for correction.Pain in nerve roots, irritation of the spinal column's own nerves, swelling, and irritation of the muscles and ligaments located in the lumbar spine innervation zone.
Pain syndrome can be caused by the compression of radicemic structures (radiculopathy), spinal cord contraction (compression myelopathy), spinal cord damage due to impaired blood supply to the bloodstream, due to the intersection of the arteries and the veins (compression-vessels).
Compression can be caused by: Intervertebral disc protrusion and hernia, spondylolists (spine advancement), growth of osteophytes and cartilage tissues in the vertebrate segment.ResultOsteochondrosis of the lumbar regionThe spine causes narrowing of the channel through which the cerebrospinal nerves or vascular structures pass through, and under certain conditions (awkward movement, physical activity, failure of the body, etc.) may occur (weakening).Compression of nerve structures causes various pain syndromes, muscle spasms.Compression of blood vessels causes blood supply to the blood supply - begins with ischemia of the body, which is fed from this vessel or artery.
Clinical syndromes of lumbar spine osteochondrosis
The clinical picture of lumbar osteochondrosis is defined by the complex of the spine symptoms (changes in lumbar spine statistics and dynamics) and congenital symptoms that are understood as a impaired function of neurological and vascular structures in the lumbombach region of the spine.
Lumbar osteochondrosis spine syndromes
With lumbar osteochondrosis, vertebrate syndrome is characterized by the following complex of symptoms:
- Disruption of Functional-Anatomical Segment Configuration: Shattering of lordosis, scoliosis or lordicolosis or (less frequently);
- Disruption of mobility in the lumbar region, decrease in the volume of movements, a tonic imbalance of muscles caused by both deep and superficial multilateral muscle tension;
- Local pain and pain with active and passive movements, which causes reflex tonic muscle tension;
- Disruption of spring-driving functions, both intervertebral disc and, generally, the spine-on-the-segment;
- Local pain of bone tumors in the affected side (increased sensitivity) (pain during palpation, local (regional) spine and/or spine pain syndrome).
It is important to note that with osteochondrosis of the lumbar department, spine pathologies are always observed.Signs of myelopathy, radiculopathy, and myeloradiculopathy without obvious clinical and morphological signs of spine syndrome usually require more patient examination for the primary ("non -sort") nervous system.
Extroverrial (reflex and compression) syndromes for lumbar spine osteochondrosis
Extrovernial syndromes are divided into two large groups: reflex and compression.
Reflex syndromesThey precede compression and are caused by irritation of the nerve root receptors that arise from the spinal canal through intervertebral holes.Irritation can be caused by intervertebral hernia, bone growth, as well as vascular disorders (swelling, impaired blood flow) and inflammation.In some cases, this causes intense pain, which occurs not only locally but also in the nerve, from the area of irritation -so called "pains", the pain can be short and severe ("shift") or stupid long -term.Vegetation disorders (burning, shrubs, decreased sensitivity) are possible in the area of damaged nerve innervation.Myofasic pain is possible - muscle spasms that cause movement limits.
Reflex syndromes include lumbago ("shift") to the acute development of the disease and lumbalgia with a subacute or chronic course.
Compression syndromes are syndromes that occur as a result of compression, nerves, blood vessels, spinal cord disorders, in the area of lumbar spinal segments.Compression syndromes for osteochondrosis of the lumbosacal section are divided into radical and vascular-brown.A special case of compression syndrome is myelopathy - spinal cord disorders.
Medicinal syndromes (radiculopathy) are usually caused by a disk prosthesis, which causes cerebrospinal root disorders.In this case, the radical symptoms arising correspond to the level of the affected spine segment.Most often, the roots of L4-S1 are affected.
Vascular-brown neurological disorders are caused by the contraction of the spine hernia and passed through the root artery.At the same time, "paralytic Ishia" can develop catastrophically, characterized by peripheral paresis or paralysis of the legs of the foot extensor.In such cases, the appearance of motor disorders is accompanied by the disappearance of pain.
Even more severe neurological manifestations are caused by disruption of spinal cord blood supply due to damage to radical-grown arteries.At the same time, chronic discriminatory myelopathy develops, usually the lumbar spine thickening.
The most undesirable version of lumbar radicular syndromes is the compression of the "horse tail" - the so -called "horse's tail".Tail syndrome.Most often, this is caused by a disk medal for the fall of the hernia, which occupies all roots at the level of the affected segment.
What is osteochondrosis of the lumbar spine?What are its symptoms?How to treat lumbar osteochondrosis?
Clinical classification of osteochondrosis of the lumbar region.The degree of osteochondrosis
Classification of lumbar osteochondrosis by degree is used for systematic characteristics of 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
This occurs when a sharp movement or overtvoltage is caused by an intervertebral disc.It is manifested by sudden pain, the spine is produced by the feeling of electric current, the muscles are reflexively tense.
2 degrees of osteochondrosis
The second degree can be manifested as symptoms of intervertebral protrusion and spine instability.Chronic pain increases during cargo.Remission and exacerbations intervals of alternative.The cervical region is characterized by pain in the neck, increasing after a long stay in one condition, headache, pain in the hands, shoulder pain, periodic discomfort, or numbness in the fingers.For lumbar region - lower posterior pain, glutal region, periodic pain in communion, frequent fatigue in the legs.
3 degrees of osteochondrosis
It manifests itself in the intervertebral disc hernia (with pain, arms or legs of the affected nerve, walking, headache) or distant symptoms of intervertebral hernia (cervical spine spine, noise of ear violence: heart rhythm, difficulty breathing;
4 degrees of osteochondrosis
It is generally accepted that the fourth degree of osteochondrosis begins from the moment when the hernia is no longer detected, the manifestations of the disease may be reduced, but the symptoms of spinal instability, decreased or deviation from the spine, or their complete fixation.The growth of the growth of the spine (osteophytes) may also be joined by those that can also weaken the spinal nerves or overlap the spinal canal (secondary spinal canal stenosis) and stop the spinal cord (spinal cord ischemia).In addition, the fourth degree involves the results of surgical intervention if the hernia is immediately removed (various types of innervation, parasite, inflammation).
Treatment of lumbar spine osteochondrosis
With lower posterior pain, it is necessary to consult a physician to determine the diagnosis to exclude kidney colic, appendicitis or other disease that requires urgent medical attention.
If the cause of spinal pain is known, and this exacerbation of osteochondrosis of the lumbar spine, it is first necessary to maximize the load on the spine.It is necessary to keep bed rest for 3 to 7 days - sometimes only this can significantly reduce pain.But in order to accelerate recovery, proper or effective treatment is required.He must stimulate his own protective and health processes in the human body.Treatment should take into account the localization of the injury, the stage of the disease, the functional condition of the body and its individual systems.Surgical treatment of this disease is indicated only in very severe cases.Most often, different methods of conservative treatment of osteochondrosis are used.
Conservative treatment of lumbar osteochondrosis
Conservative treatment methods are primarily a treatment of drug addiction.To reduce pain as well as to reduce inflammation, which is often the cause of spine syndrome, in the form of tablets or in acute cases - in the form of injections - in the form of injections.Occasionally, after injection, the painkiller calms down and does not refresh even when the duration of the medicinal product ends.This means that it is possible to break a vicious circle in which the pain causes muscle cramps and muscle tension, in turn, exacerbating pain.However, if the pain persists for a long time, it is important to remember that NSAIDs usually have side effects and prolonged use can cause unwanted complications - reducing leukocyte counts, gastrointestinal tract complications.
Often, soothing agents are prescribed to improve the general condition of patients for 1-3 weeks, as well as small doses of antidepressants.Novocaine blockade is produced by osteochondrosis of the lumbar spine.Recently, anticonvulsants have been successfully used to relieve pain.
To reduce compression syndromes, manual therapy, traction treatment (spinal cord) and in special cases - surgery.
When weakening the fixation properties of the ligament and consistency of the spine, it is advisable to use fixing devices - corsets, collars, garments, etc.And patients with spinal osteochondrosis are very important in the future to strengthen the muscle corset.
After removing acute symptoms, the task of creating muscle fixation comes first and then stimulates the regeneration processes of damaged structures.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use chondroprotectors (medication to restore cartilage tissue).Also drugs that improve the condition of the blood vessels (angioprotectors), vitamins, primarily B group, calcium preparations that improve bone tissue condition.
Physiotherapeutic procedures are widely used to treat osteochondrosis of the spine.They reduce tissue pain and swelling, improve blood circulation and stimulate muscle fixation.Merging procedures, alternative.Such methods of physiotherapeutic treatment as:
- Darsonvalization of the affected area of the posterior and affected limbs;
- Electrophoresis;
- Low energy laser radiation;
- Ultrasound;
- Magnetic field impact;
- Thermal procedures.
Successfully used in conditions of sanatorium, mud, ozokeritis, paraffin applications, radon, sulfide, hydrogen sulfide, turpentine and other baths;
It should be remembered that for the development of complete regeneration, it takes quite a long time, in favorable circumstances it happens in the sixth month.Therefore, the treatment should be long.It should be carried out in a combined way, that is, combined medicines with physiotherapy and physiotherapy exercises.