Osteochondrosis is the most severe form of degenerative -dystrophic lesion of the spine, which is based on the defeat of the pulpic nucleus of the intervertebral disk, with subsequent deformations of the bodies of adjacent spines, intervertebral joints, introduced ligamental apparatus, and involves the pathological process of the nervous system and the swindle.
One of the most common forms of osteocondrosis is osteochondrosis in the lumbar area, or more precisely the lumbosacral spine.For a lot - both men and women - are familiar with back pain in the crucifix, sacrum, lower extremities, caused by different types of lumbar osteochondrosis and its complications.Among the causes of temporary disabilities and disabilities, this disease occupies one of the first places.
The course of the disease is chronic, usually with periods of aggravations.Most often, the deterioration of osteochondrosis of the lumbar line and the transfer of weights, hypothermia, stress and damage causes.
Osteocondrosis of the lumbar spine - causes, mechanism for occurrence and development
There was no clear cause of osteocondrosis, the disease is considered polyphals.The most popular theory is, after which the cause of osteocondrosis of the spine is the constant overwhelming of the muscles or the hypotension of muscles, non -physiological muscle tension, leading to overloading vertebral segments, which is the result of their blood supply and ultimately to the degeneration of intervertebral slices and collapse,is the result of the result of the etching of intervention osteochondrosis.
The reason for premature aging of the intervertebral discs can also be endocrine and metabolic disorders, a hereditary disposal for the development of osteocondrosis, autoimmune disorders and microtrauma.The negative role of viscerceal, that is, related to internal organs, pathologies in the development of osteocondrosis of the spine, has also been proven.A significant role in the development of the disease belongs to adverse.The contribution of hereditary factors to the appearance of lumbar osteochondrosis is approx.60%, the rest refers to the factors of negative external influence on the spine.
Factors that contribute to the development of osteocondrosis both in the lower back and other parts of the spine are very numerous.Head of them: Incorrect attitude, hypodynamia, muscle overgrazing in the lumbar range as a result of constant wearing weights or a sharp excessive strain, hormonal restructuring, endocrine and somatic diseases, violation of normal blood supply to the tissue in the spine, emotional stress, age -related changes, poor nutrition.Under the influence of these factors in the spine structures, the processes of dehydration and circulatory disorders, arthrosis and subluxation in small joints, bone growth and disks - are gradually increasing.
The most obvious causes of lumbar skeletos are most often considered a sedentary lifestyle and back injury.Therefore, the risk group primarily includes the people whose profession is directly related to the loads on the back.This is a very wide range of occupations - selling and servants, surgeons and teachers - all who are forced to spend most of working hours standing.The risk group includes builders and movements as well as athletes who, in the nature of the activity, occur large loads on the spine.In addition, drivers, various office workers, programmers - that is, those who have worked mostly sedentary and who suffer from hypodynamia, of osteocondrosis in the lower back.
Symptoms of osteocondrosis in the lumbar spine
OnLumbar osteochondrosisPainful sensations of different characters are possible.This can either be sore pain that occurs with a long -lasting seat or after sleep, as well as sharp shooting that causes in the most unpleasant position and does not allow to fix.The pain is clamped by the nerve roots, the irritation of the own nerves in the spine, edema and irritation of the muscles and the ligament, which is located in the innervation zone of the lumbar spine.
The pain syndrome may be caused by the compression of radicemical structures (radiculopathy), the spinal cord compression (compression mylopathy), damage to the spinal cord due to decreased blood supply due to pushing, constriction (stenosis) of supply arteries and veins (compression-vessel-mylohemia).
The cause of the compression can be: projections and hernia of the intervertebral disks, spondylolistz (slides back forward relative to the underlying), the growth of oste whites and cartilage tissue in the vertebrate.As a resultOsteocondrosis in the lumbar areaThe spine leads to a narrowing of the duct through which the cerebrospinal nerves or vascular structures pass, and under certain conditions (awkward movement can physical activity, a failed turning of the body, etc.), compression (clamp) occur.Compression of nervous structures leads to various pain syndromes, muscle spasms.Compression of blood vessels causes a violation of the blood supply - the ischemia of the organ feeding from this vessel or artery begins.
Clinical syndromes of osteocondrosis in the lumbar spine
The clinical image for lumbar -skin -skintochondrosis is determined by a complex of back symptoms (a change in statics and dynamics of the lumbar spine) and the escorted symptoms that are understood as a violation of the function of neurological and vascular structures in the lumbarian region of the back.
Vertebral syndromes of lumbar huddtochondrosis
With lumbar osteochondrosis, the vertebral syndrome is characterized by the following symptom complex:
- Violation of the configuration of the spinal functional anatomical segment: a flattening or (less often) increase in lordosis, scoliosis or lordoscoliosis is observed;
- Violation of mobility in the lumbar area, a decrease in the amount of movements, the muscle-tonic imbalance caused by the tension of both deep and superficial multi-human muscles;
- Local pain and tenderness with active and passive movements, causing reflex tonic muscle tension;
- Violation of the Spring Motor's functions for both the intervertebral disc and generally the vertebral-motor segment;
- Local tenderness (increased sensitivity) of the bones of the bone structures of the spine in the affected area (pain during palpation, local (regional) spine and/or vertebrae syndrome).
It is important to note that with osteocondrosis in the lumbar department, vertebral pathologies are always observed.The presence of signs of myelopathy, radiculopathy and myeloradiculopathy without obvious clinical and morphological signs of the spine usually requires one more in the best examination of the patient for the primary ("non -sorester") damage to the nervous system.
Extrovertebral (reflex and compression) syndromes for osteocondrosis of the lumbar spine
Extrovertebral syndromes are divided into two large groups: reflex and compression.
Reflex syndromesThey precede compression and are caused by irritation of the receptors of the roots of nerves coming out of the spinal canal through the intervertebral holes.Irritation can be caused by intervertebral hernia, bone growth and vascular disorders (edema, blood circulation worsen) and inflammation.In some cases, this leads to intensive pain that occurs not only locally, but also during the nerve at a distance from the place of irritation -the so -called "reflected pain", reflected pain can be short and acute ("shift") or stupid long -term.In the innervation zone of the damaged nerve are vegetative disorders (combustion, goosebumps, reduced sensitivity) possible.Myofascial pain is possible - muscle spasm leading to limiting movements.
Reflex syndromes include lumbago ("shift") in the acute development of the disease and lumbalgia with subacute or chronic course.
Compression syndromes are syndromes that occur as a result of compression, violation of nerves, blood vessels, spinal cord in the area with the lumbar spinal cord segments.Compression syndromes for osteocondrosis in the lumbosacral department are divided into radicular and vascular brown.A special case of compression syndrome is myelopathy - violation of the spinal cord.
Remedy syndromes (radiculopathy) are usually due to the projection of the disk, causing violation of cerebrospinal nuts.The radicular symptoms that occur in this case correspond to the level of the affected vertebral segment.Most often, the roots are affected by L4-S1.
Vascular brown neurological disorders are caused by the compression of hernia on the spine and the root artery passing with it.At the same time, "paralyzing ishias" can develop disastrously, characterized by peripheral palsy or paralysis of the muscle in the foot delay.In such cases, the appearance of motor disorders of the disappearance of pain is accompanied.
Even more severe neurological manifestations are caused by a violation of the blood supply to the spinal cord due to damage to the radical-spinal arteries.At the same time, chronic discirculatory mylopathy develops, usually at the level of lumbar thickening of the spinal cord.
The most unfavorable version of the lumbar vertical radicular syndromes is the compression of the "horse's tail" - the so -called caudal syndrome.Most often it is caused by the falling medinal hernia on the disk, which is pressed all roots at the level of the affected segment.
What is osteocondrosis in the lumbar spine?What are its symptoms?How to treat the lumbar osteocondrosis?
Clinical classification of osteocondrosis in the lumbar area.Degree of osteocondrosis
The classification of the lumbar osteochondrosis according to degrees is used for the systematic properties of the clinical manifestations of the disease.This classification systematically describes the symptoms of the disease and begins from the moment the patient is in pain.
1 degree of osteocondrosis
It occurs when the intervertebral disk caused by a sharp movement or overvoltage occurs.It is manifested by a sudden pain, in the spine occurs a feeling of passage of electric current, the muscles are reflexively tense.
2 degree of osteocondrosis
The second degree can manifest itself in the form of symptoms of intervertebral projections and instability of the spine.Chronic pain increased by loads.The intervals of remission and worsening change.The cervical region is characterized by pain in the neck, which increases after a long stay in a position, headache, pain in the hand, shoulder pain, periodic discomfort or numbness in the fingers.For the lumbar area - low back pain, pain in the gluteal region, periodic pain in the sacrum, frequent fatigue in the legs.
3 degree of osteocondrosis
It manifests itself in the form of symptoms of hernia of the intervertebral slice (pain along the affected nerve, numbness in the arms or legs, a change in progress, headache) or remove symptoms of the intervertebral hernia (in the cervical spine: frequent headaches, noise in the ears, dizziness, fall of heartbeat, breathing;
4 degree of osteocondrosis
It is generally accepted that the fourth degree of osteocondrosis begins from the moment when hernia no longer manifests, the manifestations of the disease may decrease, but the symptoms of the spinal cord instability, sliding or twisting the vertebrae or their complete fixation is still relative to each other.The manifestations of the growths of the spines (osteophy huts) can join those who can also squeeze the spinal cord nerves or overlap the spinal canal (secondary stenosis in the spinal canal) and squeeze the spinal cord (spinal cord gami).In addition, the fourth degree includes the consequences of surgical intervention if the hernia was removed quickly (various forms of innovation, palsy, inflammation).
Treatment of osteocondrosis of the lumbar spine
With the first acute low back pain, it is necessary to consult a physician to establish a diagnosis to exclude an attack of kidney colic, appendicitis or any other disease that requires acute medical treatment.
If the cause of back pain is known and this worsening of osteocondrosis of the lumbar spine, first and foremost it is necessary to maximize the load on the spine.It is necessary to observe bed rest for 3 to 7 days - sometimes only can only reduce the pain.But to speed up improvement, it is necessary correctly, ie effective treatment.It should stimulate its own protective and health processes in the human body.Treatment should take into account the location of the lesion, 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 are used for conservative treatment of osteocondrosis.
Conservative treatment of lumbar -osteocondrosis
Conservative treatment methods are first and foremost drug treatment.To reduce pain as well as to reduce inflammation, which is often the cause of the vertebral syndrome, - not -steroidal anti -inflammatory drugs (NSAIDs) are prescribed in the form of tablets or - in acute cases - in the form of injections.Sometimes, after injection, a painkiller, the pain calms down and does not resume even when the duration of the medical substance ends.This means that it was possible to break the vicious circle where the pain leads to muscle cramps and muscle tension on its side improves pain.But if the pain lasts for a long time, it is important to remember that NSAIDs usually have different side effects, and with prolonged use, unwanted complications - a decrease in the number of leukocytes in the blood can be complications from the gastrointestinal tract.
Often, soothing (soothing) agents are prescribed to improve patients' general condition within 1-3 weeks as well as small doses of antidepressants.With osteochondrosis of the lumbar spine, Novocaine blockade is produced if necessary.Recently, medication of anticonvulsiva began to be used successfully to relieve pain.
To reduce compression syndromes, manual therapy, traction treatment (spinal cord) and in special cases - surgery are used.
When weakening the fixation properties of the ligamental and the consistency apparatus on the spine, it is recommended to use fastening devices - corsets, collars, dressings, etc.And patients with spinal osteochondrosis are extremely important in the future to strengthen their own muscle cross.
After removing acute symptoms, the task of creating muscle fixing comes first in the first place and then stimulate the regeneration processes for damaged structures.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use chondroprotectors (drugs to recover cartilage tissue).As well as drugs that improve the condition of blood vessels (angioprotector), vitamins, primarily group B, calcium preparations that improve the condition of bone tissue.
Physiotherapeutic procedures are used widely for the treatment of osteochondrosis.They reduce tissue pain and edema, improve blood circulation and stimulate muscle fixation.Procedures can be combined, alternative.Such methods of physiotherapeutic treatment as:
- Darssonvalization of the affected area of the back and the affected limbs;
- Electrophoresis;
- Low -Energilaser radiation;
- Ultrasound;
- exposure to the magnetic field;
- Thermal procedures.
Under the conditions of the sanatorium, mud, ozokeritic, paraffin applications, radon, sulfide, hydrogen sulfide, turpentine and other baths are used successfully;
It should be remembered that for the development of full regeneration, it takes a fairly long period under favorable circumstances, it occurs in the sixth month.Therefore, the treatment must be long.It must be performed in a combined way, that is, combined drugs with physiotherapy and physical therapy exercises.