Lumbar osteochondrosis is a chronic disease that develops as a result of a degenerative-distribution process in intervertebral discs.The disease is widespread and affects in most cases of people aged 25 to 40 years.
According to the back pain statistics, at least once in your life every adult is suffering, while in 95% of cases they are due to spine osteochondrosis.
Patients with a severe course of lumbar osteochondrosis, with persistent pain and other manifestations are recognized as a disabled temporarily.If within four months your condition does not improve, the issue of establishing a disability group will be resolved.
Lumbar osteochondrosis is a serious medical and social problem, as the disease mainly affects people of the older work and, in addition to the absence of treatment, can cause intervertebral disc hernia formation.
Causes and Risk Factors
The factors that predispose to the development of lumbar osteochondrosis are:
- abnormalities of the spine structure;
- Lombalization is a congenital pathology of the spine, characterized by the separation of the sacred first vertebra and its transformation in the sixth (additional) lumbar;
- Sacralization is an innate pathology, in which the fifth lumbar vertebra is fed with the sacred;
- the asymmetrical location of the articular cracks of the intervertebral joints;
- Pathological narrowing of the spinal canal;
- Reflected (somatic and muscles) sports aches;
- obesity;
- sedentary lifestyle;
- prolonged exposure to vibration;
- Systematic physical tension;
- Smoking.
ADVERSE STATODYNAMIC LOADS combined with one or more risk factors lead to a change in the physiological properties of the core of a fibrous disc jacket, playing a shock absorbent role and providing spinal spine mobility.The basis of this process is the depolmerization of polysaccharides, which leads to the loss of moisture with a fabric of the jet core.As a result, the core of the jacket and, with it, the fibrous disc loses its elastic properties.Other mechanical loads cause protrusion of the fibrous ring that has lost its elasticity.This phenomenon is called protrusion.The cracks appear in the fibrous nucleus, through which the fragments of the jacket core (prolapse, hernia of the intervertebral disc) fall.
A long compression of the nerve roots that innervate certain organs of the abdominal cavity over time leads to a deterioration in its operation.
The instability of the spine segment is accompanied by reactive changes in adjacent vertebrae bodies, intervertebral joints and concomitant spondil arthrosis.A significant muscle contraction, for example, against the bottom of physical activity, leads to a change in vertebral bodies and violation of nerve roots with the development of root syndrome.
Osteophytes may be another cause of pain and neurological symptoms with lumbar osteochondrosis - bone growth in vertebra processes and bodies that cause RoyShold syndrome or compression myelopathy (spinal cord compression).
Forms of the disease
Depending on which structures are attracted to the pathological process, lumbar osteochondrosis is clinically manifested by the following syndromes:
- Reflection- Lumbalgia, LumboIchachalia, Lumbago;develop at the bottom of the reflex overtension of the muscles of the back;
- compression (spine, vascular, root)- Their development is leading to the compression (compression) of the spinal cord, blood vessels or nerve roots.Examples are lumbosacra radiculitis, radiculoiremia.
Symptoms of Lumbar Osteochondrosis
With lumbar osteochondrosis, symptoms are determined by which structures are attracted to the pathological process.
Lumbago occurs under the influence of hypothermia or physical overvoltage and sometimes for no apparent reason.The pain appears suddenly and is firing.This intensifies by sneezing, coughing, body curves, physical effort, seat, foot, walking.In the lying position, the pain is weakening significantly.Sensitivity and reflexes are preserved, the volume of movements in the lower back is reduced.
In palpation, they observe:
- Lumbar pain;
- Spasm of the paravertebral muscles;
- The flattening of lumbar lordosis, which in many cases is combined with scoliosis.
Lumbar nerve root tension syndrome is negative.When lifting a straight leg, patients observe increased pain in the lower back, not their appearance in an elongated lower limb.
Often, with lumbar osteochondrosis, there is a repeated occurrence of pain attacks, which become increasingly intense and long.
With lumbaly, the clinical picture resembles a lumbago, however, an increase in pain intensity occurs within a few days.
In a lumbar form, patients complain of pain in the lower back, which radiate to one or both lower limbs.The pain spreads over the buttocks and the back of the thigh and never reaches the feet.
Vasomotor disorders are characteristic of lumbar spine:
- Changes in the temperature and skin color of the lower ends;
- feeling of heat or cold;
- Violation of blood supply.
The development of lumbar compression syndromes is manifested clinically by the following symptoms:
- Dermatomic gipalgesia;
- Shooting pains;
- weakening or complete loss of deep reflexes;
- Peripheral paresis.
With compression syndromes, the pain intensifies as it tilt the body, sneezing and cough.
Diagnosis
The diagnosis of lumbar osteochondrosis is made based on the clinical picture of the disease, laboratory and instrumental research methods.
In blood tests at the bottom of lumbar osteochondrosis, it can be noted:
- decreased calcium concentration;
- increased VHS;
- Increasing the level of alkaline phosphatase.
In the diagnosis of lumbar osteochondrosis, the radiological examination of the spine is important.
A long compression of the nerve roots that innervate certain organs of the abdominal cavity over time leads to a deterioration in its operation.
X -ray resources confirming the diagnosis are:
- Change in the configuration of the affected segment;
- Pseudospondylastez (Change of Related Vertebral Bodies);
- Closing plates deformation;
- intervertebral disk flattening;
- The unequal height of the intervertebral disc (symptom of the spacer), which is associated with asymmetrical muscle tone.
Also in the diagnosis of lumbar osteochondrosis in the presence of indications:
- Myelography, calculated or magnetic refusal tomography - is required for persistent symptoms, the development of neurological deficiency;
- The scintigraphy (the study of the accumulation of a phosphorus bone system, a molten technology-99)-is performed in case of suspected tumor or infectious process, an injury to the spine.
The differential diagnosis of lumbar osteochondrosis is performed with the following diseases:
- Spondylolistz;
- spectacular spondylopathy;
- Ankylosing spondylitis (ankylosing sponneum);
- Infectious processes (disks inflammation, spine osteomyelitis);
- non -plastic processes (primary spine tumor or its metastatic lesions);
- Rheumatoid arthritis;
- Osteoarthritis of hip joint deformation;
- Reflected pains (diseases of internal organs and large blood vessels).
Treatment of lumbar osteochondrosis
With lumbar osteochondrosis, they usually adhere to the following treatment tactics:
- rest in bed for 2-3 days;
- the traction of the affected segment of the spine;
- Strengthening the rear and abdominal press muscles (the creation of the called muscle corset);
- Impact on myofascial and myotonic processes.
Lumbago occurs under the influence of hypothermia or physical overvoltage and sometimes for no apparent reason.
In most cases, conservative treatment of lumbar osteochondrosis is performed, including the following measures:
- muscle infiltration with a solution of local anesthetics;
- take non -non -esteroid anti -inflammatory drugs;
- reception of desensitizing agents;
- Vitamin therapy;
- Reception of tranquilizers and antidepressants;
- Manual therapy, massage;
- Physical Education of Physiotherapy;
- acupuncture;
- Post -Isometric relaxation.
The absolute indications for the surgical treatment of lumbar osteochondrosis are:
- Acute or subacute compression of the spinal cord;
- The development of horse tail syndrome, characterized by the impaired function of the pelvic organs, sensitive disorders and motor.
Medical gymnastics for osteochondrosis lumbar
In complex treatment of lumbar osteochondrosis, a significant role belongs to physical therapy exercises.Regular classes make it possible to normalize the muscle tone of paravertebral muscles, improve metabolic processes in the tissues affected by the pathological process and, besides forming a well -developed muscle corset that can keep the spine in the right position, remove excellent static loads.
So that gymnastics with lumbar osteochondrosis to bring the greatest effect to adhere to the following principles:
- regularity of the classes;
- gradual increase in the intensity of physical effort;
- Avoiding overwork during the lesson.
Physical education must be involved in leading an experienced instructor who will select the most effective exercises for a particular patient and control the correction of their implementation.
According to the back pain statistics, at least once in your life every adult is suffering, while in 95% of cases they are due to spine osteochondrosis.
In addition to classes with an instructor, you should perform a morning gymnastics complex daily, which includes special exercises with lumbar osteochondrosis.
- Relaxation and contractions of the abdominal muscles.The starting position is standing, the legs are apart from the width of the shoulder, the hands of the body are lowered.Make a soft breath, relaxing the muscles of the anterior abdominal wall.During exhalation, be based as much as possible, forcing the press muscles.Exercise should be repeated before the appearance of fatigue of light.
- Head movement with spine flexion.The starting position of the knees, resting on the floor of the back, the back is straight.Lift your head slowly and folds your back.To stay in this position for a few seconds and then gently return to your original position.Repeat at least 10 to 12 times.
- "Pendulum".The starting position lying on the back, the arms along the body, the legs are folded at straight angles in the knee and hip joints.Turn your legs right and left with pendulum -shaped movements swinging, trying to take the floor.At the same time, the shoulder blades cannot be torn from the floor.
- "Boat".The starting position to lie in the stomach, the hands are extended forward.Torn the upper body and leg legs, bending in the back.To remain in this position for 5-6 seconds and slowly return to the starting position.Run 10 times.
Possible consequences and complications
The main complications of lumbar osteochondrosis are:
- intervertebral hernia formation;
- Vegetable dystonia;
- SPONDYLOLIS, SPONDYLOLISTZ;
- osteofitosis;
- spondylartrosis;
- Spinal canal stenosis, leading to spinal cord compression and capable of causing persistent loss of work capacity and reducing quality of life.
A long compression of the nerve roots that innervate certain organs of the abdominal cavity over time leads to a deterioration in its operation.As a result, patients have intestinal dysfunctions (constipation, diarrhea, flatulence) and pelvic organs (urination disorders, erectile dysfunction, frigidity, infertility).
Forecast
Pain syndrome for lumbar osteochondrosis continues in the form of remissions and exacerbations.Lumbago lasts from 10 to 15 days, after which the patient's condition improves, the pain disappears.Apartic secondary diseases can interfere with a favorable result.Often, with lumbar osteochondrosis, there is a repeated occurrence of pain attacks, which become increasingly intense and long.
In complex treatment of lumbar osteochondrosis, a significant role belongs to physical therapy exercises.
Patients with a severe course of lumbar osteochondrosis, with persistent pain and other manifestations are recognized as a disabled temporarily.If within four months your condition does not improve, the issue of establishing a disability group will be resolved.
Prevention
The prevention of the development of spine osteochondrosis is the following measures:
- Smoking refusal;
- Standardization of body weight;
- Improvement of general physical condition, active lifestyle;
- Avoiding provocative conditions (weight lifting, clear movements, curves, inclinations).