Osteochondrosis is the most severe form of the degenerative dystrophic lesion of the spine, which is based on the defeat of the pulp core of the intervertebral disc, with subsequent deformations of the body adjacent vertebrae, the patalic and photographed fours -fours and flexible tapral and list -catching tapral and listed orders.
One of the most common forms of osteochondrosis is the osteochondrosis of the lumbar region or more precisely the lumbar spine.For many - both men and women - are familiar with back pain in the lower back, sacrums, lower extremities, caused by different types of lumbar balosteochondrosis and their complications.Under the reasons for temporary disability and disability, this disease occupies one of the first places.
The course of the disease is chronic, usually with exacerbation times.Most of the time, the exacerbations of the osteochondrosis of the Lumbal linema -Lift and the transfer of weights, hypothermia, stress and injury are provoked.
Osteochondrosis of the lumbar spine - causes, mechanism of occurrence and development
There was no clear cause of osteochondrosis, the disease is considered polyfaver.The most popular theory, according to which the cause of the osteochondose of the spine is the constant overload of the muscles or the hypotension of the muscles, is not -physiological muscle tension that leads to overloading the spine segments, the deterioration of your blood supply and ultimately, and its success.Osteochondrosis.
The cause of the early aging of the intervertebral discs can also be endocrine and metabolic diseases, an inherited disposition for the development of osteochondrosis, autoimmune diseases and microtrauma.The negative role of the viser, i.e. in connection with internal organs, pathologies in the development of osteochondrosis of the spine, has also been proven.An important role in the development of the disease is part of undesirable inheritance.The contribution of hereditary factors to the occurrence of lumbar osteochondrosis is about 60%, the rest refers to the factors of the adverse external influence on the spine.
Factors that contribute to the development of osteochondrosis both in the lumbari and in other parts of the spine are very numerous.The main aid: hypodynamy, muscle overvoltage in the lumbar industry due to the constant wearing of weights or a sharp excessive stress, hormonal restructuring, endocrine and somatic diseases, disturbing the normal blood supply to the spine, emotional stress, age changes, bad food.Under the influence of these factors in the structures of the spine, the processes of dehydration and circulatory diseases, osteoarthritis and subluxation in small joints, bone growth and discs gradually increase.
The most obvious causes of lumbar osteochondrosis are most often regarded as a sedentary lifestyle and back injury.Therefore, the risk group mainly includes people whose profession is directly related to the loads on the back.This is a very wide range of professions - seller and waiter, surgeons and teachers - everyone who is forced to spend most of the working hours.The risk group comprises builders and makers as well as athletes, which are created in the type of activity of large loads on the spine.In addition, the drivers, various office workers, suffer from programmers - that is, those who suffer from the most seated work and suffer from hypodynamy from osteochondrosis of the lumbar effect.
Symptoms of osteochondrosis of the lumbar spine
AtLumbale osteochondrosisPainful sensations of different nature are possible.This can either be painful pain that occurs with a longer seat or after sleep, as well as sharp shots that are caused in the most unpleasant pose and do not allow the possibility to set up.The pain is caught by the nerve roots, the irritation of your own nerves of the spine, edema and irritation of the muscles and ligaments in the interior zone of the lumbar spine.
Pain syndrome can be caused by compression of radicemic structures (radiculopathy), the compression of the spinal cord (compression myelopathy) and the damage to the spinal cord due to impairment of blood supply due to pressing, narrowing (stenosis) of the supply arteries and vascular myelemia).
The reason for the compression can be: ahead and hernia of the intervertebral discs, spondylolistz (the vertebrae in relation to the underlying vertebrae), the growth of osteophytes and cartilage tissue in the spine.As a result ofOsteochondrosis of the lumbar regionThe spine leads to a narrowing of the channel through which the cerebrospinal nerves or vascular structures pass, and under certain conditions (unpleasant movement, physical activity, an unsuccessful application of the body, etc.) can occur.The compression of nerve structures leads to various pain syndromes, muscle cramps.The compression of blood vessels leads to a violation of blood supply - the ischemia of the organ, which feeds on this vessel or artery.
Clinical syndromes of osteochondrosis of the lumbar spine
The clinical image for the lumbar osteochondrosis is determined by a complex of vertebral symptoms (a change in the statics and dynamics of the lumbar spine) and the escorted symptoms, which are understood as a violation of the function of neurological and vascular structures in the lumbosacral region of the spine.
Vortical syndromes of lumbar osteochondrosis
In lumbar osteochondrosis, the vertebral syndrome is characterized by the following complex of symptoms:
- Violations of the configuration of the spinal functional-anatomical segment: flattening or (less often) increase in lordosis, scoliosis or lordoscoliosis is observed;
- Violation of mobility in the lumbar region, a decrease in movement volume, the muscle tonic imbalance, which is caused by the tension of depths and superficial multi-human muscles;
- Local pain and pain with active and passive movements that cause reflex -tonic muscle stresses;
- Violation of the feather -engine functions of both the intervertebral disc and the vertebral engine segment;
- Local pain (increased sensitivity) of the bone mixing structures of the spine in the affected area (pain during the palpations, local (regional) vertebral and/or vertebrosonal pain syndrome).
It is important to note that osteochondrosis of the lumbar department is always observed.The presence of signs of myelopathy, radiculopathy and myeloradiculopathy without obvious clinical and morphological signs of vertebral syndrome usually requires more in the depth of the patient for the primary ("not Orester") damage to the nervous system.
Extrovetebral (reflex and compression syndromes for osteochondrosis of the lumbar spine
Extrovetebral 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 roots of the nerves that appear through the land of the swing holes from the spine canal.The irritation can be caused by intervertebral hernia, bone growth and vascular disorders (edema, deterioration of the bloodstream) and inflammation.In some cases, this leads to intensive pain, which not only locally, but also in the course of the nerve at a distance from the stimulus place -the so -called "reflected pain", reflected pain can be short and acute ("shift") or stupid in the long term.In the intentional nerve's innovation zone, vegetative diseases (burning, goosebumps, impaired sensitivity) are possible.Myofascial pain is possible - muscle cramp, which leads to limited movements.
The reflex syndromes include Lumbago ("shift") in the acute development of the disease and lumbargia with subacute or chronic course.
Compression syndromes are syndromes that occur due to compression, violation of nerves, blood vessels and spinal cord in the area of the lumbar spine.Compression syndromes for the osteochondrosis of 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 projections of the hard drive, which leads to a violation of cerebrospinal roots.The radicular symptoms that occur in this case correspond to the level of the affected spine.The roots of L4-S1 are mostly affected.
Neurological vascular brown diseases are caused by the compression of the hernia on the spine and the root artery that passed with it.At the same time, "paralytic Ishias" can develop catastrophically, characterized by peripheral paresis or paralysis of the muscle of the footwobs.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 spinal cord's blood supply due to damage to the radicular spinal arteries.At the same time, a chronic discrtScullatory myelopathy develops, usually at the level of the lumbar thickening of the spinal cord.
The most unfavorable version of the vertical radicular syndrome of the lumbar spine is the compression of the "ponytail" - the so -called Caudal syndrome.Most of the time, it is caused by the falling medal hernia of the disc, which presses all roots at the level of the affected segment.
What is osteochondrosis of the lumbar spine?What are his symptoms?How do you treat osteochondrosis of the lumbar spine?
Clinical classification of the osteochondrosis of the lumbar region.Degree of osteochondrosis
The classification of 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 has pain.
1 degree of osteochondrosis
It occurs when the intervertebral disc caused by a sharp movement or overvoltage occurs.It manifests itself through a sudden pain, in the spine there is a feeling of the passage of electrical current, the muscles reflexively tense up.
2 degrees of osteochondrosis
The second degree can manifest itself in the form of symptoms of intervertebral advantage and the instability of the spine.Chronic pain increases at loads.The intervals of remission and deterioration alternate.The cervical region is characterized by pain in the neck and after a long stay in a position, headache, pain in the hand, shoulder pain, periodic symptoms or numbness in the fingers.For the lumbar industry - pain in the lower back, pain in the buttocks region, periodic pain in the sacrum, frequent tiredness in the legs.
3 degrees of osteochondrosis
It Manifests Itself In The Form of Symptoms of the Hernia of the Intervertebral Disc (Pain Along 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,Dizziness, decreease in vision, muscle strength in the Hands of the Thoracic: Violation of the Cordial Region: Violation of the heart rhythm, difficulty in the lumbar spine: kidney disease, gastrointestinal tract, violations in the genital area, numbness or weakness in the legs).
4 degrees of osteochondrosis
It is generally recognized that the fourth degree of osteochondrosis begins from the moment when the hernia can no longer manifest itself, the manifestations of the disease can take off, but the symptoms of the spine in stability, slip or twisting the vertebrae or their complete fixation are still in relation to each other.The manifestations The growth of the vertebral bodies (osteophytes) can combine that also press the back reserves or overlap the vertebral canal (secondary stenosis of the back canal) and the spinal cord (spinal cords -peak).In addition, the fourth degree includes the consequences of surgical intervention when the hernia has been removed immediately (different types of innervation, paresis, inflammation).
Treatment of osteochondrosis of the lumbar spine
With the first acute pain in the lower back area, it is necessary to consult a doctor to make a diagnosis to rule out an attack on kidney colic, appendicitis or other diseases that need medical emergency care.
If the cause of the back pain is known and this aggravation of the osteochondrosis of the lumbar spine must first maximize the load of the spine.It is necessary to observe the bed rest for 3 to 7 days - sometimes only this can significantly reduce the pain.In order to accelerate recovery, however, it is correct to be treated effectively.It should stimulate its own protection and health processes in the human body.Treatment should take into account the localization of the lesion, the stage of the disease, the function of the body and its individual systems.The surgical treatment of this disease is only indicated in very severe cases.In most cases, various methods for conservative treatment of osteochondrosis are used.
Conservative treatment of lumbar osteochondrosis
Conservative treatment methods are initially a drug treatment.In order to reduce the pain and reduce inflammation, which is often the cause of the vertebral syndrome, non -steroidal anti -inflammatory medication (NSAIDS) in the form of tablets or - in acute cases - in the form of injections are prescribed.Sometimes the pain calms down after the injection after the injection and does not drive up again when the duration of the medical substance ends.This means that it was possible to break the vicious circle in which the pain leads to muscle cramps and the muscle tension in turn improves pain.However, if the pain takes a long time, it is important to remember that NSAIDs usually have different side effects and can cause undesirable complications with longer use -a decrease in the number of leukocytes in the blood, complications from the gastrointestinal tract.
Seasters are often prescribed (soothing) agents to improve the general condition of the patients within 1 to 3 weeks and small doses of antidepressants.With the osteochondrosis of the lumbar spine, a novocaine block is generated if necessary.Medicates from the anticonvulsant have recently been used successfully to relieve pain.
In order to reduce compression syndromes, manual therapy, traction treatment (spinal traction) and in special cases are used.
If the fixation properties of the spine of the spine become weaker, it is recommended to use fixation devices - corsets, collar, associations, etc.However, it can only be used with fixing devices, since a weakening of the muscles is observed when using the muscles.And patients with osteochondrosis with spine are extremely important in the future to strengthen their own muscle corset.
After the removal of acute symptoms, the task of creating muscle fixation comes first and then stimulates the regeneration processes of damaged structures.Use therapeutic gymnastics, reflex zone massage, massage.To do this, use chondroprotectors (medication to restore cartilage tissue).As well as medicines that improve the condition of blood vessels (angi -protectors), vitamins, mainly group B, calcium preparations that improve the condition of the bone tissue.
Physiotherapeutic methods are often used to treat osteochondose of the spine.They reduce tissue pain and edema, improve blood circulation and stimulate muscle fixation.Processes can be combined, alternatively combined.Such methods of physiotherapy treatment as:
- Daronvalization of the affected area of the back and the affected limbs;
- Electrophoresis;
- Laser radiation with low energy;
- Ultrasonic;
- Exposure to the magnetic field;
- Heat process.
Under the conditions of the sanatorium, mud, ozokerite, paraffin applications, radon, sulfide, hydrogen sulfide, turpentine and other baths are successfully used;
It must be remembered that the development of complete regeneration takes a fairly long period under favorable circumstances in the sixth month.Therefore, the treatment should be long.It should be carried out combined, i.e. combined medicines with physiotherapy and physiotherapy exercises.