Osteochondrosis is the most severe form of Degeneratibic Lesion of the Spine, Which is Based on the Defeat of the Pulpic Nucleus of the Intervertebral Disk, With Subsequent Deforma.Intervertebral Joints, Impaired Ligamentous Apparatus, and Involving The Pathological Process of the Nervous System and Blood Veseels.
One of the most common forms of osteochondrosis is osteochondrosis of the lumbar region or, more precisely, the lumbosacral spine.For many - both men and women - are familiar with back pain in the lower back, sacrum, lower limbs caused by various types of lumbar osteochondrosis and its complications.Among the causes of temporary damage and damage, this disease occupies one of the first places.
The course of the disease is chronic, usually with periods of exacerbation.Most often, the exacerbations of osteochondrosis of lumbar linear lift and weight transfer, hypothermia, stress and injury are provoked.
Osteochondrosis of the lumbar spine - causes, mechanism of occurrence and development
There was no unequivocal cause of osteochondrosis, the disease is considered a polyphaver.The most popular theory is, Accord to which the cause of osteochondrosis of the spine is the constant overwhelming of the muscles or hypotension of Muscles, Nonphysological Muscle Tensionvertebral segments, the deterioration of their blood supply and, ultimately, to the degeneration of the intervertebral discs and joints, the result of which is the result of which is the result Остеохондроза.
The reason for the premature aging of the intervertebral discs may also be endocrine and metabolic disorders, hereditary predisposition to the development of osteochondrosis, autoimmune disorders and microtraumas.The negative role of visceral, that is, related to the internal organs, has also been proven pathologies in the development of osteochondrosis of the spine.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 factors of adverse external influence on the spine.
Factors that contribute to the development of osteochondrosis in both lumbar and other parts of the spine are numerous.The main one: improper posture, hypodinamia, muscle surge in the lumbar region as a result of constant weight wearing or abrupt excessive loading, hormonal restructuring, endocrine and somatic diseases, disruption of normal blood supply to the tissue of the spine, emotional stress, age.Under the influence of these factors in the structures of the spine, the processes of dehydration and blood circulation, arthrosis and subluxation in small joints, bone growth and discs - the hernia gradually increases.
The most clear causes of lumbar osteochondrosis are most often considered a sedentary lifestyle and back injury.Therefore, the risk group includes mainly those people whose profession is directly related to back loads.This is a very wide range of professions - seller and waiters, surgeons and teachers - all who are forced to spend the bigger part of the working hours standing.The risk group includes builders and wallets, as well as athletes who who, by nature, have high loads of the spine.In addition, drivers, various office workers, programmers - that is, those who have the job mostly stuck and suffer from hypodynamia suffer from lumbar osteochondrosis.
Symptoms of osteochondrosis of the lumbar spine
Atlumbar osteochondrosisPainful sensations of different nature are possible.This one can be either pain in the pain that occurs with a prolonged seat or after sleep, as well as a sharp shooting, causing the most incapable posture and does not allow the ability to stand up.The pain is pressed by the nerve roots, the irritation of the own nerves of the spine, the swelling and the irritation of the muscles and the connections located in the area of innervation of the lumbar spine.
Pain syndrome can be caused by compression of radicemic structures (radiculopathy), compression of the spinal cord (compression myelopathy), damage to the spinal cord due to impaired blood supply, narrowing (stenosis) of the arteries of the supply and veins (compression compression and veins (compression compression and veins (compression compression and veins (compression compression and veins.
The reason for the compression may be: convexity and hernia of the intervertebral discs, spondylolist (slipping the vertebrae forward in connection with the main one), the growth of osteophytes and cartilage tissue in the vertebrae segment.As a result of thisLumbar osteochondrosisThe spine leads to a narrowing of the duct through which the cerebrospinal nerves or vascular structures pass through, and under certain conditions (uncomfortable movement, physical activity, unsuccessful turn of the body, etc.), compression (pressing) can occur.The compression of nerve structures leads to various pain syndromes, muscle spasms.The compression of the blood vessels causes impaired blood supply - the ischemia of the organ that feeds on this vessel or artery begins.
Clinical syndromes of osteochondrosis of the lumbar spine
The clinical picture of lumbar osteochondrosis is determined by a complex of vertebrae symptoms (change in static and dynamics of the lumbar spine) and the accompanied symptoms, which are understood as a violation of the function of the neurological and vascular structures in the lumbosacral region of the spine.
Spinal syndromes of lumbar osteochondrosis
With lumbar osteochondrosis, vertebrae syndrome is characterized by the following complex of symptoms:
- Disruption of the configuration of the spinal functional-anatomical segment: there is a leveling or (less) increase in lordosis, scoliosis or lordoscoliosis;
- Impaired mobility in the lumbar region, reduction of movement volume, muscle tonic imbalance caused by tension both deep and superficial multicles;
- local pain and tenderness with active and passive movements, which causes reflex tonic tension of the muscles;
- Violation of the spring-motor functions of both the intervertebral disc and the vertebral segment in general;
- Local soreness (increased sensitivity) of the bone-ligamental structures of the spine in the affected area (pain during palpation, local (regional) vertebra and/or vertebral pain syndrome).
It is important to note that with osteochondrosis of the lumbar department there are always vertebrae pathologies.The presence of signs of myelopathy, radiculopathy and myeloradiculopathy without obvious clinical and morphological signs of the vertebral syndrome requires a more thorough examination of the patient for the primary ("not -serial") damage to the nervous system.
Extrebral (reflex and compression) syndromes for osteochondrosis of the lumbar spine
Extreme syndromes are divided into two large groups: reflex and compression.
Reflex syndromesThey precede the compression and are caused by irritation of the receptors of the root of the nerves resulting from the spinal canal through the intervertebral holes.Irritation can be caused by intervertebral hernia, bone growth, as well as vascular disorders (edema, worsening of blood) and inflammation.In some cases, this leads to intense pain, which occurs not only locally, but also in the course of the nerve at a distance from the site of irritation -such as "reflected pain", reflected pain can be short and acute ("shift") or silly long -term.Vegetative disorders (burning, geese, impaired sensitivity) are possible in the area of innervation of the damaged nerve.Myophassal pain is possible - muscle spasm, which leads to restriction of movements.
Reflex syndromes include Lumbago ("Shift") in the acute development of the disease and lumbalgia with a subacut or chronic course.
Compression syndromes are syndromes that occur as a result of compression, nerve disorders, blood vessels, spinal cord in the area of lumbar spinal segments.The lumbosacral osteochondrosis compression syndromes are divided into radicular and vascular brown.A special case of compression syndrome is myelopathy - a spinal cord disorder.
The drug syndromes (radiculopathy) are usually due to a bulge of the disc, causing a disturbance of brain roots.Radicular symptoms that occur in this case correspond to the level of the affected vertebra segment.Most often the roots of the L4-S1 are affected.
Vascular-brown neurological disorders are caused by the compression of hernia on the spine and the root artery passing by it.At the same time, the "paralytic needles" can develop catastrophically, characterized by peripheral paresis or paralysis of the muscles of the extensions of the legs.In such cases, the onset of motor disorders is accompanied by the disappearance of pain.
Even more severe neurological manifestations are caused by a disorder of the blood supply to the spinal cord due to damage to the radicular-spinal arteries.At the same time, chronic dicirculatory myelopathy develops, usually at the level of lumbar thickening of the spinal cord.
The most favorable version of lumbar vertical radicular syndromes is the compression of the "ponytail" - the so -called caudal syndrome.Most often it is caused by the falling medial hernia on the disc, which presses all the roots at the level of the affected segment.
What is osteochondrosis of the lumbar spine?What are his symptoms?How to treat lumbar osteochondrosis?
Clinical classification of osteochondrosis of the lumbar region.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 experiences pain.
1 degree of osteochondrosis
It occurs when an intervertebral disc caused by a sharp movement or overvoltage occurs.It manifests itself from sudden pain, in the spine there is a feeling of passing electric current, the muscles are reflexively tense.
2 degree of osteochondrosis
The second degree may manifest in the form of symptoms of intervertebral convexity and instability of the spine.Chronic pain increases with loads.The intervals of remission and exacerbations alternate.The cervical region is characterized by neck pain, increasing after a long stay in one position, headache, arm pain, shoulder pain, periodic discomfort or numbness in the fingers.For the lumbar region - lower back pain, pain in the gluteal area, periodic pain in the sacrum, frequent fatigue in the legs.
3 degree of osteochondrosis
IT ManifeSts itsself in the form of symptoms of the Hernia of the Interveted Nerve, Numbness of the Arms Or Legs, A CHANNE, Headaches) Or Distant SymphasCervical Spine: Frequent Headaches, Noise in the Ears, Dizziness, Decrease in Vision, Muscle Strength in the Hands of the Thoracic: Violation of Cordial Region: heart rhythm disruption, difficulty breathing;
Grade 4 of osteochondrosis
It is generally accepted that the fourth degree of osteochondrosis begins from the moment when the hernia no longer manifests itself, the manifestations of the disease may reduce, but the symptoms of spinal instability, slipping or twisting of the vertebrae or their complete fixation is still relative to each other.The manifestations of the growth of the vertebrae (osteophytes) can join them, which can also pull the spinal nerves or overlap the spinal canal (secondary stenosis of the spinal canal) and pull out the spinal cord (ischemia of the spinal cord).In addition, the fourth degree involves the effects of surgery if hernia is eliminated immediately (various types of innervation, paresis, inflammation).
Treatment of osteochondrosis of the lumbar spine
With the first acute lower back pain, it is necessary to consult a doctor to establish a diagnosis to rule out a kidney colic attack, appendicitis or other disease requiring emergency medical attention.
If the cause of the back pain is known and this exacerbation of osteochondrosis of the lumbar spine, it is first and foremost to increase the load on the spine.It is necessary to monitor bed rest for 3 to 7 days - sometimes this alone can significantly reduce the pain.But to accelerate recovery, it is necessary properly, that is, effective treatment.It must 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 state of the body and its individual systems.Surgical treatment of this disease is only shown in very severe cases.The most common methods are used for conservative treatment of osteochondrosis.
Conservative treatment of lumbar osteochondrosis
First of all, conservative treatments are medication treatment.To reduce pain, as well as to 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.Sometimes, after injection, analgesic, the pain calms down and does not resume even when the duration of the medicinal substance ends.This means that it is possible to destroy the vicious circle, in which pain leads to muscle cramps and muscle tension, in turn, increases the pain.However, if the pain lasts for a long time, it is important to remember that NSAIDs usually have different side effects and with prolonged use can cause unwanted complications - reducing the number of leukocytes in the blood, complications from the gastrointestinal tract.
Sedative (soothing) remedies are often prescribed to improve the general condition of patients within 1-3 weeks, as well as small doses of antidepressants.With osteochondrosis of the lumbar spine, if necessary, a blockade of Novocaine is produced.Recently, anticonvulsant drugs have begun to be successfully used to relieve pain.
To reduce compression syndromes, manual therapy, adhesion treatment (spinal adhesion) are used and, in special cases, surgery.
When weakening the properties of fixing the ligamentary and consistency device of the spine, it is recommended to use fixing devices - corsets, collars, dressings and more.However, a limited time to fix devices can be used, as when used, weakening of muscles is observed.And patients with spinal osteochondrosis are extremely important in the future to strengthen their own muscle corset.
After the elimination of 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 (cartilage repair medicines).As well as medicines that improve the condition of blood vessels (angioprotectors), vitamins, mainly group B, calcium preparations that improve bone condition.
For the treatment of osteochondrosis of the spine, physiotherapy 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 physiotherapy treatment such as:
- Darsonvalization of the affected area of the back and the affected limbs;
- electrophoresis;
- low -energy laser radiation;
- ultrasound;
- exposure to the magnetic field;
- Thermal procedures.
In the conditions of the sanatorium, mud, ozocathic, paraffin applications, radon, sulfide, hydrogen sulfide are used successfully;
It must be remembered that it takes a long period of time to develop full regeneration, in favorable circumstances that occur during the sixth month.Therefore, treatment should be long.It should be done in a combined manner, that is, combined medicines with physiotherapy and physiotherapy exercises.