Lumbar osteochondrosisis one of the most common diseases of the spine.
It is characterized by deformation of the cartilaginous tissue of the vertebrae.
The spine remains flexible and mobile as long as the vertebrae are healthy.
If the condition worsens, the intervertebral discs lose elasticity and begin to dry out.
As a result, patients develop severe pain in the lumbar region.
What is it?
When dystrophic-degenerative changes appear in the vertebral tissues, they begin to gradually collapse. If the vertebrae located mainly in the lumbar region are mainly affected, then osteochondrosis of the lumbar spine is diagnosed.
Clinical presentation
In osteochondrosis, the cartilaginous tissue of the vertebrae begins to lose moisture, the elasticity of the intervertebral discs deteriorating. Over time, the height between the vertebrae decreases. Under increased load, the fibrous ring begins to crack, the intervertebral disc protruding.This leads to scratching of the nerve endings and the appearance of pain.
In the absence of adequate treatment, osteochondrosis progresses. Intervertebral discs harden, their cushioning properties deteriorate. Growths form in the bone tissue of the vertebrae, which suppress nerve endings. Because of this, patients develop persistent pain.
Degrees and Classification
Experts distinguish 4 degrees of spinal osteochondrosis:
- The process of destruction of intervertebral discs begins, the symptoms of the disease are mild, burning sensation, tingling sensation, the pain appears only after physical exertion. Patients talk about the appearance of dull back pain, sometimes they radiate to the buttocks.
- The distance between the vertebrae gradually decreases and the fibrosus ring begins to collapse. The intervertebral discs are compressed, exceed physiological limits, there is pressure on the nerve roots. Patients complain of palpable pain, which during the process of walking is given to the buttocks, thighs, lower legs. In addition to pain, a burning sensation, coldness is possible.
- Fibrous rings are destroyed, during examination, patients discover intervertebral hernia. The pain bothers me constantly, despite the load.
- The results of the bone from the vertebrae are visible. The cartilage atrophies, making it difficult for the patient to move. As a result, the lumbar spine loses movement and flexibility, and the patient becomes incapacitated.
| They also classify osteochondrosis according to the type of disease course: | |
|
|
Experts spot such a period of osteochondrosis:
- debutimi;
- deterioration;
- falja;
- stabilization.
Treatment is chosen depending on the stage of the disease, the nature of the deformity and the severity of the symptoms of the disease.
ICD 10 code
In accordance with the International Classification of Diseases, spinal osteochondrosis is assigned the code M42. Separately, there are juvenile (M42. 0), adult (M42. 1) and indefinite (M42. 9) osteochondrosis.
Prevalence and Significance
The lumbar region is more prone to developing osteochondrosis than other parts of the spine. This is due to the increased load in this area because it has to support the body weight. With a weak muscular corset, the condition of the intervertebral discs begins to deteriorate rapidly, they are destroyed.
Most often people over the age of 30suffer from osteochondrosis of the lumbar spine. Although it can be found in younger patients. Almost 80% of patients who come to doctors with complaints of pain in the lumbar region are diagnosed with osteochondrosis.
Examination of patients over the age of 40 revealed that most of them have characteristic changes in the intervertebral discs. But in the absence of clinical manifestations, a person is not considered ill.In the absence of adequate therapy, the disease progresses. In neglected forms, this leads to the inability of the patient.
Risk factors and causes
Often representatives of such professions encounter osteochondrosis: programmers, office workers, builders, loaders, waiters, drivers.
Risk factors in the presence of which increase the likelihood of developing osteochondrosis include:
- mbipesha;
- unhealthy diet;
- behavioral problems;
- genetic predisposition;
- lack of sleep;
- frequent stress;
- persistent hypothermia;
- should be in an awkward position for a long time;
- low physical activity.
Reasons for developing lumbar spine osteochondrosis include:
- natural aging processes of the body;
- metabolic problems;
- back injuries;
- back problems;
- flat feet;
- intense physical activity, such as lifting weights;
- problems with spinal joints (rheumatoid arthritis);
- endocrine diseases;
- problems with the digestive and cardiovascular systems.
Some experts believe that the tendency to develop osteochondrosis is transmitted at the genetic level.
Consequences
A change in cartilage tissue located between the vertebraeleads to worsening of the fibrosus ring and the appearance of a hernia. Patients begin to complain of severe pain in the lumbar region, which radiates to the gluteal muscles, thighs, and lower legs. But this is not the only possible complication of osteochondrosis.
Prolonged irritation of the spinal nerve leads to inflammation.Patients develop lumbar sciatica.With osteochondrosissciatica can develop(sciatica). The disease leads to severe pain, numbness of the lower back, legs. Patients begin to walk, leaning to one side. This provokes further curvature of the spine and further destruction of the intervertebral discs.
Osteochondrosis provokes vertebral instability. The lumbar region, under the influence of body weight, begins to move from the sacrum. In women, such instability provokes the appearance of problems with internal organs (uterus, ovaries, appendages suffer), in men - with potency.
When the intervertebral discs are destroyed, the blood supply to the spinal cord is disrupted, vertebral displacement leads to compression myelopathy.
The most dangerous complication is "cauda equina syndrome". It consists in the fact that the nerve roots are affected. In severe cases, osteochondrosis causes paresis of the lower extremities or paralysis of both legs.
it is possible to prevent the development of negative consequences if, when the first symptoms appear, you consult a doctor and do not ignore the need for treatment.
Symptoms
Osteochondrosis does not appear immediately. In the initial stages, the patient has no pain or discomfort. Complaints usually appear when the disease progresses to stage 2.
The main symptoms of lumbar osteochondrosis include:
- low back pain that gets worse as the disease progresses;
- impaired movement: problems appear when trying to bend, turn, sensations when changing body position are described by patients as "electric shock", pain in many of them radiates to the legs;
- change in the sensitivity of the extremities, which appeared against the background of nerve root damage, in the affected area there is a burning sensation, numbness, crawling, tingling sensation;
- muscle weakness, lack of tendon reflexes;
- local temperature drop;
- increased sweating;
- pallor, dry skin in the problem area;
- urinary disorders, sexual dysfunction (in severe osteochondrosis).
Some patients have leg artery spasm. But the symptoms are expressed only in the acute form of osteochondrosis. A deterioration can start suddenly with hypothermia, strenuous movement or after intense physical activity.
Which doctor are you treating?
If you have back pain, you shouldsee an orthopedist and neurologist. The examination assesses the patient's neurological condition, checks how the spine performs its functions. Doctors also assess the condition of the back and gluteal muscles.
For experienced specialists, an examination is sufficient to establish a preliminary diagnosis. But to confirm it, the patient is sent to the diagnostics of the equipment.
Diagnostic Methods
The simplest and most accessible method for detecting osteochondrosis isradiography. But to get a more accurate picture, a computer or magnetic resonance imaging is prescribed.
MRImakes it possible to examine the condition of the spine as accurately as possible. In fact, during the procedure, photos are taken from the problem area layer.
Treatment
The tactics of therapy are chosen by the doctor depending on the patient's condition, the stage of osteochondrosis and the clinical manifestations of the disease.
Your doctor may prescribe:
- select drug therapies, nonsteroidal anti-inflammatory drugs, hormonal drugs, analgesics;
- medication blockade, analgesics, hormonal medications are injected into the affected area or muscles located around the problem vertebra, which almost immediately relieve inflammation and relieve pain;
- manual therapy, massage, physiotherapy, recommended after stopping the acute phase of the disease, with the help of physiotherapy, you can increase the effectiveness of drug treatment;
- medical gymnastics;
- acupuncture.
Surgery is required in advanced cases. Surgical intervention is prescribed in those situations when conservative treatment does not bring the expected results.
Conclusion
With the progression ofdystrophic-degenerative changes in the cartilage tissues of the lumbar spine, osteochondrosis is diagnosed. In advanced forms, this disease can not only lead to the appearance of persistent severe pain, but also cause paresis, paralysis of the lower extremities.
- You may suspect the development of osteochondrosis from the onset of low back pain. As the disease progresses, the pain increases significantly, the lower back loses its movement.
- Depending on the degree of destruction of the intervertebral discs, there are 4 stages of the disease.
- Most often this diagnosis is made to people after the age of 30. Almost 80% of patients who go to doctors because of back pain are diagnosed with osteochondrosis.
- Those people who lead an inactive lifestyle are susceptible to osteochondrosis, are in an unnatural position for a long time, experience frequent physical overload.
- The main symptoms of osteochondrosis are pain and impaired movement of the lower back.
- Due to the destruction of the intervertebral discs in the lumbar spine, patients develop foot problems.
- If left untreated, pain intensifies,may develop sciatica, vertebral instability, compression myelopathy. In advanced cases, it paralyzes the lower limbs.
- In case of painit is necessary to consult a neurologist and orthopedist. The patient is sent for x-rays, computed tomography or magnetic resonance imaging.
- Depending on the condition,prescribes medication, blockades, massage, manual therapy, physiotherapy, physiotherapy exercises or surgeries.