Osteochondrosis of the spine is a process of degeneration of the cartilaginous tissue of the intervertebral discs. As a result of metabolic disturbances, this process can affect any part of the lumbar pole. Nevertheless, in most cases, there is osteochondrosis of the lumbar spine, the symptoms of which sometimes lead to painful suffering of the patient. This frequency of lesions is due to the anatomical and physiological characteristics of the waist, which accounts for a significant part of the static and dynamic loads. Accordingly, the bone and cartilage structures located here wear out faster.
The main symptoms of
It is noteworthy that the very process of dystrophy of the lumbar intervertebral discs passes asymptomatically, and for the time being, does not make itself known for a time. This is the cunning of osteochondrosis. The first symptoms of osteochondrosis of the lumbar spine appear only when irreversible structural changes have already developed in this anatomical region - disc hernias, pathological bone sprouting( spondylosis), infringement of nerves and vessels in the intervertebral spaces and in the spinal canal. If you briefly describe the manifestations of the lumbar osteochondrosis, they are reduced to such symptoms as:
- Skin and muscle sensitivity disorders
- Limitation of movements in the lumbar and lower extremities
- Trophic disorders of the tissues of the lumbar region, pelvis and lower limbs
- Functional disorders of the pelvic organs.
The first symptom that signals that our lower back is not all right is pain. And the intensity, nature and localization of pain in lumbar osteochondrosis can be different depending on the degree of expression of this process and the development of certain complications. At first, because of the decrease in the height of the intervertebral discs, the nerves in the foraminal holes between the vertebrae are infringed. This entails an inflammation of the roots of the spinal nerves - radiculitis, and the corresponding pain - radiculagia. A variety of radiculagia is lumbulgia - pain in the lumbar region.
Another mechanism of the appearance of pain in lumbar osteochondrosis is a displacement, or a hernia of the intervertebral disc. As a rule, the disk in the lumbar region is shifted to the side or back, irritating the roots of the spinal nerve and squeezing the spinal canal. It is noteworthy that the "weakest link" in the lumbar region is the intervertebral disc between the 4th and 5th lumbar vertebrae. This place has the greatest physical load, and it is here most often noted osteochondrosis with the development of radiculitis and hernias.
In addition, the nerve roots of this segment are involved in the formation of the sciatic nerve. Since this nerve is the most powerful in our body, the pain in the sciatic nerve( sciatica) inflammation due to the osteochondrosis of the lumbosacral spine will be very appreciable. If radiculagia, as a rule, is aching, pulling, and does not go beyond the lumbar region, this pain extends from the waist to the gluteal region, to the back surface of the thigh, shin and to the sole.
Another cause of pain in osteochondrosis is reflex muscle spasm, or so-called. Myofascial syndrome, which develops as a result of pathological muscle tension. Because of constant tension and inflammation in the muscles, lactic acid accumulates, biologically active substances are released, which entails unpleasant painful sensations. With disc hernias, not only the spinal nerves are squeezed, but also the vessels that feed the spinal cord. Develops the so-called.compression myelo-ischemia - a violation of the blood supply to the spinal cord, which manifests itself, among other things, painful sensations. From all this it follows that the pain in lumbar osteochondrosis is multifaceted, and consists of the bone, nervous, muscular and vascular component. In most cases, the occurrence of pain is preceded by some provoking factors:
- Physical stress
- Accuracy in nutrition
- Psychoemotional stress.
Sensitive and Movement Disorders
Pain in the pathology of the girdle will never be isolated. She is always accompanied by other signs of osteochondrosis of the lumbar spine. First of all, these are sensory and motor disorders. After all, with lumbar osteochondrosis, not only the posterior, sensitive, but also the anterior, motor roots of the spinal nerves are impaired. In addition, due to disc hernias narrowed spinal canal. Therefore, these disorders, like pain, are different in nature of origin and character of manifestation.
A typical example of such violations is the limitation of movements in the lumbar spine. One of the reasons for this limitation is lumbar spondylosis. This pathological process is characterized by marginal bony expansions( osteophytes) of vertebral bodies. To some extent, spondylosis stabilizes the spine, and therefore is a compensatory-adaptive mechanism for osteochondrosis. True, we pay for this by reducing the volume of movements in the waist with leanings forward, to the sides.
In the pathological process with lumbar osteochondrosis, lower limbs will necessarily be involved. In this case, violations of sensitivity and movements vary widely. Sensitivity disorders will be manifested by various paresthesias in the lower extremities - sensations of numbness, burning, cold snap. And motor disorders are most often manifested by intermittent claudication. Intermittent claudication in osteochondrosis is false and is caused by disc hernia and compression of the lumbosacral plexuses. The main clinical difference between false intermittent claudication and the true claudication resulting from occlusion of arteries of the lower limbs is that it disappears when the patient tilts forward when the pressure of the displaced disc on the nerve fibers weakens.
The most severe symptoms of the lumbar spine are paralysis and paresis of the lower extremities. Do not confuse the paresis with the cut wound. Recall that paralysis is a complete lack of sensitivity and movement in the pathological zone, and paresis is partial. Depending on how much sensitivity and movement suffer, paresis can be superficial and deep. The main causes of paresis and paralysis in lumbosacral osteochondrosis are the aforementioned myelo-ischemia and horse tail syndrome.
What is this tail like? The fact is that in an adult the length of the spinal cord is less than the length of the spinal canal. The spinal cord ends somewhere between the 1st and 2nd lumbar vertebrae. This is due to the anatomical inconsistency of the spinal segments and the exit points of the spinal nerves from the spine. In the lumbar spinal cord, the nerve fibers are collected in a bundle, which because of its similarity with the tail of the horse has received this name. When narrowing the spinal canal and squeezing these fibers, the horse tail syndrome develops. In addition to severe pains, it manifests itself as paresis or paralysis of the lower limbs, as well as disruption of the internal organs.
Trophic and functional disorders of
In the syndrome of the ponytail, fibers that innervate not only the skeletal musculature but also the internal organs are affected. The level of the lumbar and sacral segments corresponds to the organs of the small pelvis - with the bladder with the urethra, the rectum. Therefore, the neurological symptomatology in this case is manifested by incontinence of urine and feces. True, such symptoms are found only with the launch of lumbosacral osteochondrosis.
With the start of osteochondrosis, trophic changes in the limbs develop. Because of trophic disturbance and innervation of the muscles of the thighs and shins, they "dry up", and, as a consequence, a decrease in the volume of the lower limbs. At the same time the skin wrinkles, thins, turns pale, begins to peel off. Due to dystrophic disorders, the ligamentous apparatus of the joints suffers;periarthrosis of the lower extremities with inflammation of the periarticular tissues.
The basic principles of treatment of any osteochondrosis, including lumbar including:
- Physiotherapeutic procedures
- Therapeutic gymnastics
- Sanatorium treatment.
The aim of all these methods is to eliminate pain, stabilize the spine, strengthen the muscular back skeleton, release the strangulated nerves, improve metabolic processes in the organs and tissues of the back and waist, and thus eliminate, if not all, many negative manifestations of lumbar osteochondrosis.
The use of medicines is precisely aimed at anesthetizing and reducing inflammatory processes in the strangulated nerves. These are analgesics and non-steroidal anti-inflammatory drugs. In order to improve metabolic processes, immunostimulants, vitamins, and fortifying agents are prescribed.
But medicines alone are not enough to eliminate the negative symptoms of low back osteochondrosis. We need physical therapy, massage, physiotherapy. In the treatment of lumbar osteochondrosis, untraditional remedies have proven themselves - manual therapy, acupuncture, osteopathy.
Unfortunately, these methods are also ineffective at far advanced stages of lumbar osteochondrosis with pronounced disc displacement or horse tail syndrome. In these cases, the operation is shown - removal of the displaced disc( a diskectomy), or a modern modification of this intervention - microdiscectomy. Recently, more and more often, various methods of laser correction of displaced intervertebral discs of the lumbar region have been used.
In addition, we recommend reading about the most common causes of low back pain.