Osteochondrosis is the most severe form of the dystrophic degenerative lesion of the spine, which is based on the defeat of the pulpable nucleus of the intervertebral disc, with subsequent deformations of the adjacent vertebrate bodies, intervertebral joints, insanitary ligament devices and ligament apparatuses and devices in the blood.
Osteochondosis in the lumbar region, or, more precisely, is one of the most common forms of osteochondrosis is one of the most common forms of osteochondrosis is one of the most common forms of osteochondrosis is one of the most common forms of osteochondrosis, or, more specified - men and women - know backs of the back,The sacrum, the lower limbs, caused by various types of lumbar osteochondosis and its complications.Among the reasons for temporary disability and disability, this disease occupies one of the first places.
The course of the disease is chronic, generally with periods of exacerbations.Most often, exacerbations of osteochondrosis of lumbar limbo and weight transfer, hypothermia, stress and injuries are caused.
Osteochondrosis of the lumbar column - causes, occurrence and development mechanism
There was no unambiguous cause of osteochondrosis, the disease is considered polyfaven.The most popular theory is, according to which the cause of osteochondrosis of the spine is the crushing constant muscles or the hypotension of the muscles, non -physiological deterioration, which leads to overloading vertebral segments, the deterioration of their osteochondrosis blood supply.
The cause of premature aging of intervertebral discs can also be endocrine and metabolic disorders, a hereditary predisposition to the development of osteochondosis, autoimmune disorders and microtraumator.The negative role of visceral, which is linked to internal organs, pathologies in the development of osteochondrosis of the spine, has also been proven.An important role in the development of the disease belongs to unfavorable inheritance.The contribution of hereditary factors to the appearance of lumbar osteochondosis is around 60%, the rest refers to the unfavorable external influence factors on the spine.
The factors that contribute to the development of osteochondrosis both in lumbar and in other parts of the spine are very numerous.The main of them: incorrect posture, hypodynamia, muscle overvoltage in the lumbar region due to the constant port of weight or a strong excessive load, hormonal restructuring, endocrine and somatic diseases, from the violation of normal blood supply to the tissue of the spine, emotional stress, changes linked to age, poor nutrition.Under the influence of these factors in the structures of the spine, the processes of dehydration and circulatory disorders, osteoarthritis and subluxation in small joints, bone growths and discs - hernias gradually increase.
The most obvious causes of lumbar osteochondosis are most often considered as a sedentary lifestyle and back injuries.Consequently, the risk group mainly includes people whose profession is directly linked to the rear loads.It is a very wide range of professions - seller and servers, surgeons and teachers - all those who are forced to spend most of the working time.The risk group includes manufacturers and movers, as well as athletes who, in the nature of the activity, arise large loads on the spine.In addition, engines, various office employees, programmers-that is to say those who have mainly sedentary work and who suffer from hypodynamia, suffer from the lumbar osteochondrosis.
Symptoms of osteochondrosis of the lumbar column
HASLumbar osteochondrosisPainful sensations of various nature are possible.This can be a painful pain that occurs with a prolonged seat or after sleep, as well as lively shots, causing the most uncomfortable installation and not allowing the opportunity to straighten up.The pain is pinching by the nerve roots, the irritation of the own nerves of the spine, the edema and the irritation of the muscles and ligaments located in the area of innervation of the lumbar column.
Pain syndrome can be caused by the compression of radicemic structures (radiculopathy), compression of spinal cord (compression myelopathy), damage to spinal cord due to altered blood supply due to the push, the narrowing (stenosis) of the arteries of food and veins (myelohemia ofcompression-state-alcohémia).
The reason for compression can be: the projections and hernia of the intervertebral discs, spondylolistz (sliding the vertebra forward compared to the underlying), the growth of osteophytes and cartilaginous tissues in the vertebral segment.ThereforeOsteochondrosis in the lumbar regionThe vertebral column leads to a shrinking of the canal through which the cerebrospinal nerves or the vascular structures pass, and under certain conditions (awkward movement, physical activity, an unsuccessful turn of the body, etc.), compression (compression) can occur.The compression of nerve structures leads to various pain syndromes, muscle spasms.The compression of the blood vessels causes a violation of blood supply - the ischemia of the organ which feeds on this vessel or this ship begins.
Clinical syndromes of osteochondrosis of the lumbar column
The clinical image of lumbar osteochondosis is determined by a complex of vertebral symptoms (a change in statistics and dynamics of the lumbar column) and escorted symptoms, which are understood as a violation of the function of neurological and vascular structures in the lumbosacral region of the vertebral column.
Vertebral syndromes of lumbar osteochondrosis
With lumbar osteochondrosis, vertebral syndrome is characterized by the following complex symptoms:
- Violation of the configuration of the functional-anatomical segment of the spine: an increase in flattening or (less often) of lordosis, scoliosis or lordoscoliosis is observed;
- Violation of mobility in the lumbar region, a decrease in the volume of movements, the muscle imbalance-tone caused by the tension of the deep and superficial multi-human muscles;
- Local pain and pain with active and passive movements, which causes a reflex tonic muscular tension;
- violation of spring engine functions both of the intervertebral disc and, in general, of the vertebral-motor segment;
- Local pain (increased sensitivity) of bone ligament structures of the spine in the affected area (pain during palpation, vertebral and / or local vertebrosonal (regional)).
It is important to note that with osteochondrosis of the lumbar department, vertebral pathologies are always observed.The presence of signs of myelopathy, radiculopathy and myeloradiculopathy without clinical and morphological signs obvious to vertebral syndrome requires, as a rule, a more late examination of the patient for primary damage ("non-specialized") to the nervous system.
Extreme syndromes (reflex and compression) for the lumbar column osteochondrosis
Extreme syndromes are divided into two large groups: reflex and compression.
Reflex syndromesThey precede compression and are caused by the irritation of the roots of the emerging nerves of the spinal canal through the intervertebral holes.The irritation can be caused by an intervertebral hernia, bone growth, as well as vascular disorders (edema, aggravation of blood circulation) and inflammation.In some cases, this leads to intensive pain, which occurs not only locally, but also during the nerve at a distance from the place of irritation - "thoughtful pain", reflected pain can be short and acute ("change" or stupid in the long term.In the damaged nerve innervation area, vegetative disorders (burning, goosebumps, altered sensitivity) are possible.Myofascial pain is possible - muscle spasms, which leads to limiting movements.
Reflex syndromes include lumbago ("quarter") in the acute development of disease and low background with a subabid or chronic course.
Compression syndromes are syndromes that occur following compression, violation of nerves, blood vessels, spinal cord in the lumbar vertebral segments area.The compression syndromes of osteochondrosis in the Lombo-Sacré department are divided into radicular and vascular brown.A special case of compression syndrome is myelopathy - counterfeiting of the spinal cord.
Remedy syndromes (radiculopathy) are generally due to protuberances of the disc, causing violation of cerebrospinal roots.The radicular symptoms occurring in this case correspond to the level of the affected vertebral segment.Most often, L4-S1 roots are affected.
Vascular brown neurological disorders are caused by the compression of hernia on the spine and the root artery passing with.At the same time, "paralytic ishias" can develop catastrophically, characterized by peripheral paresis or paralysis of the foot muscle of the foot.In such cases, the appearance of motor disorders is accompanied by the disappearance of pain.
Even more serious neurological manifestations are caused by a violation of the blood supply with the spinal cord due to damage to the radicular-spinal arteries.At the same time, chronic disirculatory myelopathy is developing, generally in the lumbar thickening of the spinal cord.
The most unfavorable version of lumbar vertical radical syndromes is the compression of the "ponytail" - Caudal syndrome if called.Most often, it is caused by the fall of the medical hernia of the disc, which tightens all the roots at the level of the affected segment.
What is osteochondrosis of the lumbar column?What are its symptoms?How to treat osteochondrosis of the lumbar?
Clinical classification of osteochondrosis in the lumbar region.Degree of osteochondrosis
The classification of lumbar osteochondrosis according to diplomas is used for the systematic characteristics of clinical manifestations of the disease.This classification systematically describes the symptoms of the disease and begins from the moment the patient suffers.
1 degree of osteochondrosis
It occurs when the intervertebral disc caused by a net movement or overvoltage occurs.It manifests itself by sudden pain, in the spine, a feeling of passing the electric current occurs, the muscles are held reflexively.
2 degree of osteochondrosis
The second degree can manifest itself in the form of symptoms of intervertebral projection and instability of the spine.Chronic pain increasing to loads.Remission and exacerbations intervals alternate.The cervical region is characterized by pain in the neck, increasing after a long stay in a position, headache, hand pain, shoulder pain, periodic discomfort or numbness in the fingers.For the lumbar region - lower back, pain in the glued region, periodic pain in the sacrum, frequent fatigue in the legs.
3 degree of osteochondrosis
It is manifests itself in the form of symptoms of the hernia of the intervertebral disc (bread all the affected nerve, numbness of the arms or legs, a change in gait, headaches) or distant symptoms of the intervertebral hernia (in the cervical spine: frequent headaches, noise in the ears, dizzinessIn Vision, Muscle Strength in the Hands of the Thoracic: Violation of the Cordial Region: Violation of the heart rate, difficulty in breathing;
4 degree of osteochondrosis
It is generally accepted that the fourth degree of osteochondrosis begins as long as the hernia no longer manifests, manifestations of the disease may decrease, but the symptoms of vertebral instability, slippery or twist the vertebrae, or their complete fixation are always relative.The manifestations of the growths of vertebral bodies (osteophytes) can join them, which can also tighten the vertebral nerves or ride the vertebral canal (secondary stenosis of the vertebral canal) and press the spinal cord (ischemia of the spinal cord).In addition, the fourth degree includes the consequences of surgery if the hernia was removed quickly (different types of innervation, paresis, inflammation).
Treatment of lumbar column osteochondrosis
With the first acute back pain, it is necessary to consult a doctor to establish a diagnosis in order to exclude an attack on renal colic, appendicitis or any other disease requiring emergency medical care.
If the cause of back pain is known, and this exacerbation of osteochondrosis of the lumbar column, first of all, it is necessary to maximize the load on the spine.It is necessary to observe the rest in bed for 3 to 7 days - sometimes only it can considerably reduce pain.But in order to accelerate recovery, it is necessary to do, that is to say an effective treatment.It should stimulate its own protection and health processes in the human body.The treatment must take into account the location of the lesion, the stage of the disease, the functional state of the body and its individual systems.Surgical treatment of this disease is only indicated in very serious cases.Most often, various methods of conservative treatment of osteochondrosis are used.
Conservative treatment of lumbar osteochondrosis
Conservative treatment methods are, first of all, drug treatment.In order to reduce pain, as well as reduce inflammation, which is often the cause of vertebral syndrome, non -steroidal anti -inflammatory drugs (NSAIDs) in the form of tablets or - in acute cases - in the form of injections are prescribed.Sometimes, after injection, an pain reliever, pain calms down and does not resume 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, improves pain.However, if pain lasts a long time, it is important to remember that NSAIDs generally have various side effects and with prolonged use can cause unwanted complications - a decrease in the number of leukocytes in the blood, complications of the gastrointestinal tract.
Often, sedative agents (soothing) are prescribed to improve the general condition of patients in the 1 to 3 weeks, as well as small doses of antidepressants.With osteochondrosis of the lumbar column, if necessary, the blocking of novocaine is produced.Recently, anticonvulsants drugs have started to be used successfully to relieve pain.
To reduce compression syndromes, manual therapy, traction treatment (vertebral traction) and in special cases are used - surgery.
When weakening the fixing properties of the ligament apparatus and coherence of the spine, it is recommended to use fixing devices - corsets, necklaces, dressings, etc.However, only the limited time can be used for fixing devices, as when used, a weakening of the muscles is observed.And patients with vertebral osteochondosis are extremely important in the future to strengthen their own muscle corset.
After eliminating the acute symptoms, the task of creating muscle fixation comes first in the first place, then stimulating the regeneration processes of damaged structures.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use chondroprotectors (drugs to restore cartilage fabric).As well as drugs that improve the condition of blood vessels (angioprotective), vitamins, mainly group B, calcium preparations that improve the condition of bone tissue.
For the treatment of osteochondrosis of the spine, physiotherapeutic procedures are widely used.They reduce pain and tissue edema, improve blood circulation and stimulate muscle fixation.Procedures can be combined, alternative.Such physiotherapeutic treatment methods like:
- Darsonvalization of the affected area of the back and affected members;
- electrophoresis;
- Laser radiation with low energy;
- ultrasound;
- Exposure to the magnetic field;
- Thermal procedures.
Under the conditions of sanatorium, mud, ozokeratic applications, paraffin, radon, sulfide, hydrogen sulfide, turpentine and other baths are successfully used;
It should be remembered that for the development of a complete regeneration, it takes a fairly long period, in favorable circumstances, it occurs in the sixth month.Therefore, the treatment must be long.It must be done in a combined manner, that is to say drugs combined with physiotherapy and physiotherapy exercises.