Lumbar osteochondrosisis one of the most common diseases of the spine.
It is characterized by deformation of the cartilage 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 tissues of the vertebrae, they begin to gradually collapse. If the vertebrae located in the lumbar region suffer mainly, then osteochondrosis of the lumbar spine is diagnosed.
Clinical presentation
In osteochondrosis, the cartilage tissue of the vertebrae begins to lose moisture, the elasticity of the intervertebral discs deteriorates. Over time, the height between the vertebrae decreases. Under the increased load, the annulus fibrosus begins to crack, the intervertebral disc protrudes.This leads to pinched nerve endings and pain.
In the absence of adequate treatment, osteochondrosis progresses. The intervertebral discs harden, their cushioning properties deteriorate. Growths form on the bone tissue of the vertebrae, which press down on the nerve endings. Because of this, patients develop constant pain.
Degrees and Classification
Experts distinguish 4 degrees of spinal osteochondrosis:
- The process of destruction of the intervertebral discs begins, the symptoms of the disease are mild, a burning sensation, tingling, 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 annulus fibrosus begins to collapse. The intervertebral discs are compressed, go beyond the physiological boundaries, there is pressure on the nerve roots. Patients complain of tangible pain, which in 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, intervertebral hernias are revealed in patients. Pain bothers constantly, regardless of the load.
- Bony outgrowths from the vertebrae are visible. Cartilage atrophies, it becomes difficult for the patient to move. As a result, the lumbar spine loses mobility and flexibility, and the patient becomes disabled.
| They classify osteochondrosis also by the type of disease course: | |
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Experts distinguish such a period of osteochondrosis:
- debut;
- aggravation;
- remission;
- stabilization.
Treatment is selected 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 was assigned the code M42. Separately, there are juvenile (M42. 0), adult (M42. 1) and unspecified (M42. 9) osteochondrosis.
Prevalence and Significance
The lumbar region is prone to the development of osteochondrosis more than other parts of the spine. This is due to the increased load on this area, because it must support the body weight. With a weak muscle corset, the condition of the intervertebral discs begins to deteriorate rapidly, they are destroyed.
Most often, people who have crossed the 30-year marksuffer 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 sick.
In the absence of adequate therapy, the disease progresses. In neglected forms, it leads to the patient's disability.
Risk factors and causes
Often, representatives of such professions encounter osteochondrosis: programmers, office workers, builders, loaders, waiters, and a driver.
Risk factors, in the presence of which the likelihood of developing osteochondrosis increases, include:
- being overweight;
- unhealthy diet;
- problems with posture;
- genetic predisposition;
- lack of sleep;
- frequent stress;
- constant hypothermia;
- the need to be in an uncomfortable position for a long time;
- low physical activity.
The reasons for the development of osteochondrosis of the lumbar spine include:
- natural aging processes of the body;
- metabolic problems;
- back injuries;
- back problems;
- flat feet;
- intense physical activity, such as weightlifting;
- problems with the joints of the spine (rheumatoid arthritis);
- endocrine diseases;
- problems with the digestive and cardiovascular system.
Some experts believe that the propensity to develop osteochondrosis is transmitted at the genetic level.
Consequences
A change in the cartilaginous tissue located between the vertebraeleads to a deterioration of the annulus fibrosus 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 sciatica lumbar.
With osteochondrosissciatica may develop(inflammation of the sciatic nerve). The disease leads to severe pain, numbness in the lower back and 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 instability of the vertebrae. The lumbar region, under the influence of the weight of the body, begins to move from the sacrum. In women, such instability provokes the appearance of problems with internal organs (the uterus, ovaries, appendages suffer), in men - with potency.
When the intervertebral discs are destroyed, the blood supply to the spinal cord is disrupted, the displacement of the vertebrae leads to compression myelopathy.
Cauda equina syndrome is considered the most dangerous complication. 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, 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. Usually complaints appear when the disease progresses to stage 2.
The main symptoms of lumbar osteochondrosis include:
- lumbar pain that worsens as the disease progresses;
- impaired mobility: problems appear when trying to bend over, turn around, the sensations when changing the position of the body are described by patients as "electric shock", pain in many of them radiates to the leg;
- change in the sensitivity of the extremities, which appeared against the background of damage to the nerve roots, in the affected area there is a burning sensation, numbness, crawling creeps, tingling;
- muscle weakness, lack of tendon reflexes;
- local temperature drop;
- increased sweating;
- pallor, dry skin in the problem area;
- urination disorders, sexual dysfunction (in severe osteochondrosis).
Some patients have a spasm of the arteries in the legs. But the symptoms are expressed only in the acute form of osteochondrosis. An exacerbation can begin suddenly with hypothermia, awkward movement, or after intense physical activity.
Which doctor is treating?
If you have lower back pain, you shouldsee an orthopedist and a 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, one examination is enough to establish a preliminary diagnosis. But to confirm it, the patient is sent for hardware diagnostics.
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. Indeed, during the procedure, layer-by-layer pictures of the problem area are taken.
Treatment
The tactics of therapy are selected by the doctor depending on the patient's condition, stage of osteochondrosis and clinical manifestations of the disease.
The doctor may prescribe:
- drug therapy, nonsteroidal anti-inflammatory drugs, hormonal drugs, analgesics are selected;
- drug blockade, analgesics, hormonal drugs are injected into the affected area or muscles located around the problem vertebra, which almost instantly relieve inflammation and remove pain;
- manual therapy, massage, physiotherapy, is recommended after stopping the acute stage of the disease, with the help of physiotherapy, you can enhance the effectiveness of drug treatment;
- medical gymnastics;
- acupuncture.
Operation 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 lead not only to the appearance of constant severe pain, but also cause paresis, paralysis of the lower extremities.
- You can suspect the development of osteochondrosis by the appearance of lower back pain. With the progression of the disease, the pain increases significantly, the lower back loses its mobility.
- Depending on the degree of destruction of the intervertebral discs, there are 4 stages of the disease.
- More often this diagnosis is given to people after 30 years. 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 mobility of the lower back.
- Due to the destruction of the intervertebral discs in the lumbar spine, patients develop leg problems.
- If untreated, pain increases,sciatica, vertebral instability, compression myelopathy may develop. 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-ray, computed tomography or magnetic resonance imaging.
- Depending on the condition,is prescribed medication, blockades, massage, manual therapy, physiotherapy, physiotherapy exercises or surgery.