Destructive disorders can develop in any section of the spine, but the high load in the lower back as a result of a person's directs determines the appearance of changes in this segment.Osteochondrosis is accompanied by pain in the lower back.Only a doctor can correctly determine the symptoms and treatment of pathology.In therapy, medications and exercise are used in advanced stages, surgery may be required.As an addition to the main treatment, the use of folkloric medicines is allowed.
What is osteochondrosis
With osteochondrosis, a pathological change begins - with a pulpic nucleus of intervertebral discs with a gradual transition to the fabric of a fibrous ring.It weakens, cannot withstand a growing load as a result of a partial and then complete movement of the disk of its physiological position.This happens when fibrous fibers can't stand growing pressure and breakage.
As the disc structure destroys, the destruction of nearby tissues is progressing.The involvement of the closest vertebrae, their joints and ligaments begins in the pathological process.Any vertebra has a spongy substance from within and an external compact contour consisting of records.The outer layer provides hardness and allows to support heavy loads.The vertebra also has a red bone marrow responsible for hematopoiesis.
For a long time, with osteochondrosis, complex vascular and biochemical changes occur.Bone tissue is constantly changing: some cells are destroyed, the new ones come in their place.Usually, with constant load, the formation of more durable and solid cells is stimulated.Therefore, with excessive overloads, the predominance of dense tissue is formed.
The Causes of Pathology
The characteristics of modern life and a strong decrease in human motor activity lead to a weakening of muscle fibers and a decrease in their tone.In an ordinary person, the back in the part of the day is mainly a folded position, which leads to the excessive purchase of the flexion muscles.This factor is considered the main one of provoking degenerative changes.
There are several theories of the origin of osteochondrosis:
- Involutionary.The etiology of the disease is the wear of the discs.This is especially facilitated by a sedentary lifestyle and the presence of bad habits.
- Muscle.The violations in the spinal spine structure are due to the underdevelopment or weakening of the muscle corset of the rear or constant muscle cramps, as well as inflammatory processes in them and the ligament apparatus.The stereotype of muscle movement created incorrectly mild to degeneration is believed to be.Contributes to the constant excessive overload of the involution of cartilage and other spinal structures.
- Autoimmune.The process of destruction of intervertebral vertebrae and discs develops according to the same scheme as rheumatoid arthritis.Such an assumption is considered close to the truth, since the biochemical disorders of collagenosis are very similar to changes in disc discs, leading to a deterioration in tissue and dystrophy.
The influence of internal organs pathology was also proven, as well as the presence of constant microtraums in the development of osteochondrosis.
There is a theory about a hereditary predisposition of a person in this disease;Some doctors say violations are sometimes caused by a change in metabolic processes and deviation in internal secretion work.
In many patients with pronounced disorders, chronic infection focuses are determined.
In connection with slow progression, it is read that osteochondrosis develops under the influence of various etiological moments at the same time.
Development mechanism
All symptoms that are characteristic of a dystrophic disorder in the lower back can be divided into two large groups: inner (spinal) and extroverrebial.
The latter are divided into reflex and compression.Depending on the severity of the lesion and the presence of complications, four stages of the disease are distinguished:
- The fibrous ring under the influence of excess cargo and other factors begins to change the structure: cracks are formed in it.The substance of the core of the jacket penetrates them.Reflex reactions occur as a result of irritation of nerve fibers innervating periosteum, ligament apparatus, fibrous ring.Its irritation occurs as a result of pressure when a hernia is formed, local edema or inflammation.This violation leads to the appearance of vasomotor or dystrophic changes.As a result, a person experiences intense, permanent pain or shot.Reflex disorders of chronic osteochondrosis in the lumbar segment lead to the development of lumbago and lumbalgia.And myophage pain lead to limiting movements.Radiculopathy acts as a compression syndrome, which most often accompanies damage to the lumbosacro segment.
- Pathology progression leads to an increase in intervertebral disc prolapse with its penetration in the epidural region.The vertebrae join and exert different pressure on nerve roots.It can be expressed in constant irritation or severe compression.These manifestations mark the second stage with the development of discogenic radiculitis.Most of the time, this phenomenon is observed from the fourth lower back to the first sacral vertebra.
- This stage is characterized by a continuation of hernia pressure in the nervous and vascular beam.This ends with the appearance of paresis or paralysis in the extensor muscle of the foot.At the same time, pain syndrome decreases or disappears.
- With the last degree, the blood supply and the innervation of the spinal cord are disturbed by the appearance of devoid myelopathy.Changes become stable and are poorly provided to adjust the drug.
Clinical symptoms and syndromes
Manifestations of degenerative deviations in the lower back are manifested by the pain of various intensity and duration.In addition, a person feels tired, which increases until the end of the day, he sleeps badly and gets angry.At first, symptoms pass or are reduced after a night of rest or remain in a horizontal position, but painful sensations are observed in the morning.For this reason, the patient is forced to reduce his physical activity.
Lumbar problems lead to irritation and inflammation of nerve endings, including the innervative organs of the pelvis.Therefore, with advanced pathology, urination is impaired, problems in the work of internal genital organs are observed.In men, impotence develops in this context.
The irradiation of pain and impaired sensitivity concerns the lower ends.The patient observes a burning sensation and "crawling with goose bumps", the skin on the legs is pale, dry and removes.
Lumbar spinal osteochondrosis is manifested by several syndromes, whose degree of manifestation varies in several patients.
Koreshka
The pain in this case occurs as a result of root injury, is acute, located in the damage area and enters the leg zone, buttocks, hips and feet.To reduce unpleasant sensations, a person changes the usual march and leans to the back of the violation.The pain is accompanied by sweat, which is replaced by chills, intensifies when trying to move sharply after a state of rest.
Due to a decrease in muscle tone and its gradual atrophy, it is impossible to do common work.At an advanced stage, limb paralysis develops, violation of internal organ work in the pelvis.
Ischemic
Osteochondrosis is accompanied by damage not only to nerve endings in the lower back, but also to blood vessels.Its compression leads to spasm, which becomes constant as it gets worse.Clinically, this phenomenon manifests itself in the form of intermittent chroma.
Lack of nutrients and oxygen occurs in the pelvis organs.This exacerbates the problems of urination, defecation and power even more.
Pain
The appearance of pain is the first sign of osteochondrosis.Its intensity depends on the degree of damage.At first, the pain is short, disappearing after rest, but since the beginning of the disease is long and painful.The aggravation of the pathology leads to the appearance of clear fires with radiation in the leg, groin, buttocks.
In a late phase, suffering is caused not only by physical effort, but even by cough or sneezing.In the lower back, muscle hardening is palpated, which is in a constant spastic state.
Vertebrate
With constant pain, innervation and blood supply, significant deformation occurs.Rightness is noticeable not only in the field of pathological process, the architectural of the spine of the spine is interrupted.Muscle tone decreases, they occur to the pelvis and the pelvic inclination.The march changes, it becomes uncertain.Gradually, there is a restructuring of the entire musculoskeletal system.
Osteochondrosis complications
If you do not treat the disease in the early stages, complications are developing gradually, many of which significantly reduce quality of life and even reduce its term.A neglected dystrophic process leads to the following violations:
- Muscle weakness, atrophy and astenia;
- Violation of urination and defecation (incontinence);
- the development of severe spinal deformation in men in physical work and women during pregnancy;
- Violation of power in men;
- decreased blood flow and the development of ischemia;
- Protrusion and hernia of the intervertebral disc;
- spondylartrosis (growth of stuffed processes);
- paresis of the foot;
- Spondylosis.
An important point in considering the clinic of lumbar osteochondrosis is the presence of reflected pain.Injection of nerve beams leads to irritation of internal (visceral) organs, causing pain and functional function in them.This explains the development of manifestations such as difficulty in breathing, arrhythmias, intestines that accompany the pathology of the spine.
Treatment Methods
For the treatment of lumbar spine osteochondrosis, several methods are used.
Medicine
The medications for the treatment of the disease are NSAIDs.They allow you to simultaneously eliminate the inflammation process and reduce pain syndrome.Simultaneously with drugs for internal use, local therapy with ointments and gels with anti -inflammatory effects is recommended.Most of the time, sodium diclofenac is used, ibuprofen in tablets or capsules.Sometimes, with intolerance to anti -inflammatory drugs, painkillers are used.
With intense pain, local blockages with novocaine or lidocaine are kept.In some cases, with inflammation pronounced simultaneously during paravertebral block, glucocorticoids are used with novocaine.This allows you to influence afferent conductivity and normalize the reflex activity of the over -disrupting parts of the nervous system.
A good result in muscle spasm is shown by central muscle relaxants, a typical representative of this class is Midokalm.These medications are combined with non -esteroid anti -inflammatory, increasing the effect of anesthesia and the restoration of movement in full.
Additional drug treatment includes sedatives and medications to normalize nervous system work.For this, it is sometimes recommended to take antidepressants, antipsychotics or tranquilizers.
Vitamin complexes that include group B, vitamin D and calcium help improve nerve conductivity and metabolic processes.To restore the cartilage structure, prolonged use of chondroprotectors is used.
Physiotherapy
Modern physiotherapy techniques are an integral part of the successful treatment of lumbar spine osteochondrosis.These include:
- The use of currents of various frequency and intensity.Usually, a current effect is used with a force of up to 100 mA, amplipult (modulated currents), darshasonval, electrophoresis with analgesic substance and proteolytic enzymes.Methods can improve blood circulation in the damage zone, restore metabolic processes, increase blood flow and deliver the drug directly to the point of application.
- Laser use.Its exposure reduces the inflammation and pain activity and, when directed to stopping points, it allows to restore the structure of intervertebral discs.
- UFO.With the help of ultraviolet irradiation, heating is performed, vitamin D production and calcium metabolism optimization.
- Magnetotherapy.It consists of the use of an induction magnet to restore regenerative processes at the level of cellular structures.
- Balneotherapy.It provides the use of water and curative mud.For this purpose, the patient is recommended to take ordinary and local baths, conduct applications and compresses.
Physiotherapy and Massage
An important bond in treatment is physical education.Its implementation is mandatory, but the selection of movements must be performed by a specialist.Classes allow to restore muscle tone, strengthen their fibers, expand the volume of movements in the spine.For a positive result, certain rules must be observed:
- You cannot exercise if they cause pain or excessive stress;You should start training under the control of an exercise instructor;
- Physical education should be done regularly, only in this condition the formation of a muscular corset will occur;
- Do not make movements markedly and very fast, a medium or slow pace is usually recommended;
- Gymnastics is not performed with the exacerbation of any disease;
- In case of deterioration, you must immediately interrupt the exercise and consult an expert.
It is better to select exercises that are performed in the position of lying and standing on all fours.It is useful to stretch the column, lower the press and return.For this patient, a good method of rehabilitation after an exacerbation of osteochondrosis will be a visit to the pool.
Massage is also an effective method of osteochondrosis therapy in the lumbar segment.
An experienced expert will help improve metabolic processes and microcirculation in the violation zone, relieve muscle tension.The use of massage in the acute period is extended, in the presence of serious irreversible deformations, open wounds, rashes or skin burns.
Surgery
In the absence of complex conservative therapy results, it remains only to use the radical treatment method.It consists of conducting an operation in the spine in order to eliminate compression of nerve roots and the maximum possible restoration of spine mobility or stabilize its affected segment.
The indications for the operation are:
- inter -rack horny development development;
- intense pain, which is not interrupted by the use of medicines and block;
- Full drop on the disc with the development of the syndrome and caudal ischemia;
- The emergence of signs of radiculomylocemia.
Most of the time, the patient is performed by microdiscectomy when bone tissue maintains their integrity, and the rehabilitation process takes a short time.
There are other intervention methods:
- endoscopic nucleotomy;
- Laser vaporization of the disk;
- Plasma disc nucleoplasty.
Scientists around the world are developing for the implementation of prostheses that replace intervertebral discs.This will make it possible to rehabilitate the patient after surgery and reduce the likelihood of disability.
The use of traditional medicine
Along with the use of medicines, folkloric methods are used to treat pain in the lower back.They cannot replace complete osteochondrosis therapy, but allow remission to reach remission in complex therapy:
- At home, it is convenient to use radish or rabben as compresses.They should be cut to a grater, add some cream at home and applied to the injury.
- You can spill boiling water on a bardan sheet and attach to the lower back.Cover on top with a handkerchief and hold an hour.
- Bodyaga powder, diluted 1:30 with vegetable oil, helps well.From the mixture, a great heating compression is obtained, which should be maintained for one hour.
- It is useful to rub the lower back with liquid honey.But this must be done correctly to reach a powerful blood race to the painful point.
- To remove lower back pain, the ointment is used.For manufacturing, you need to take equal actions of ghee, camphor and horsepower powder.After a complete mixture, the product is stained in pieces of rye bread and applied to the painful point.
Before using popular medicines, you should consult a doctor.
Disease prevention
To prevent the development of lumbar osteochondrosis and renewal of remission, prevention rules must be followed:
- Avoid hypothermia;
- Do not lift heavy objects (the maximum allowed load for a woman is 5 kg, for a man - 10 kg);
- Daily exercises that allow us to strengthen muscle corset and press;
- With prolonged work, make regular breaks and heat;
- While walking, always monitor your posture;
- regularly sanitize possible sources of chronic infection;
- Eat properly and prevent overweight;
- Walk at a moderate pace as long as possible;
- Visit a dance group, get involved in swimming, walking sports, avoiding sudden movements and strong jumps.
It is completely impossible to cure osteochondrosis, as changes that occur in the spine are irreversible, but modern aid methods help restore the patient's quality of life for a long time.