Probably, you can’t find a single adult who did not know what “lumbar osteochondrosis” is.On average, every third healthy person, of middle years, and sometimes more often, had in his life an episode of acute lower back pain, and every fifth - sixth indicates that such problems arise regularly, and even are a “source” of the hospital leaf.
However, to explain in detail what exactly for the violation occurred in the lower back, patients are most often not able to.Most of them have never been examined, and treatment consisting in the form of “injections”, “ointments”, massage sessions usually helps for a period of several months to a year.
If you “pose” to such a patient, and start to inquire about the diagnosis, then, having suffered a little, he will declare that he is sick with “osteochondrosis”.What does this disease mean, in relation to the lumbar spine?
Osteochondrosis of the lumbar region - a disease or "norm of life"?
First of all, you need to authoritatively say: “osteochondrosis” cannot hurt.And in any way it cannot manifest itself, since this is the process of dystrophy and degeneration of the intervertebral discs, that is, cartilage, which consist of a pulpic nucleus and a fibrous ring.The intervertebral disk is cartilage, and is designed to work as a shock -absorbing “airbag”, softening vertical and angular accelerations - inhibition between adjacent vertebrae.
As you know, the cartilage is devoid of nervous and vascular tissue, so the processes that go “purely in the discs” simply cannot affect the neighboring structures, and do not appear in any way.A similar example in vertebroneurology is the hernias of the shomorle, in which the hernial protrusion is reliably covered by the spongy bone tissue of the neighboring vertebra.Intervertebral discs do not hurt.
Chondrosis (suffix “-o” denotes an increase, increase), in this case-not quite correct.It does not occur during the human life of growth and increase in cartilage.Here with fibrosis (cirrhosis) of the liver it can be noted that the mesh structure of the liver began to develop, to the detriment of the function.
And with chondrosis (or osteochondrosis), intervertebral discs only begin to change their configuration, under the influence of perennial loads.
They cause pressure on neighboring vertebrae, because, according to the law of Newton, each action at a static load gives birth to exactly the same opposition, or reaction of the support.How does osteochondrosis develop, and for what reasons this happens?
The causes of "lumbar osteochondrosis"
Signs of osteochondrosis of the lumbar region (more precisely, intervertebral discs) can be found already at a young age, especially with various violations of the musculoskeletal system.
They can be attributed, for example:
- congenital anomalies (different legs length);
- various types of flat feet (longitudinal, transverse);
- deformation of the spinal column (scoliosis);
- Spondylolistz (slipping the lower, lumbar vertebra from the sacral bone both forward and back).
All these diseases can cause or increase the shock load on the spinal column (for example, with flat feet, when the elasticity of the arch of the foot decreases), and with severe asymmetry of the spine, when the supporting function is systematically realized due to the load on the edge of the disk.
It was known that with the experiments it was found that healthy and young cartilage, if they were given a load evenly and static throughout the surface, were able to withstand up to 2000 kg and even higher for themselves.Of course, there is no such load in everyday life, but it can increase to such values when exposed to the edge of the disk.
If the area of the support is 20 times smaller, and the disk will not be so healthy (for example, in old age), then the exposure to 60-80 kg (for example, falling on ice in inclination on the side, with a load on the shoulders) can cause a disk destruction, which can be in the form of a protrusion or hernia.
It is the appearance of protrusion or hernia that indicates that the disk was deformed and even “crawled out” from one or more sides.And around the disk, as you know, there is no empty place.As soon as the disk begins to contact nerve roots, neighboring ligaments and muscles, then the consequences of osteochondrosis occur: reflex pain and muscle-tonic syndromes that make the patient turn to a neurologist, manual therapist and masseur.
In the meantime, the discs have a normal shape and wear out evenly, without extreme loads, then osteochondrosis of the lumbar spine bothers the patient no more than the usual, age abrasion of the teeth, with which the criminals are well known.How do reflex pain syndromes manifest?
Symptoms and signs of complicated lumbar osteochondrosis
You have already noticed that we diligently “breed” bridges: ordinary osteochondrosis is a completely inevitable process of ordinary aging of elastic intervertebral “gaskets” in the “Reasonable Man” type, since it moves vertically throughout life.And the “osteochondrosis” that patients with acute pain recall is a complicated condition.
We will begin, perhaps, with signs of radicular compression.Signs of lumbar osteochondrosis, of course, are associated with pain, due to the segmental nerve spine pressed by the disk.In addition to pain, sensitive, motor and vegetatively trophic disorders are possible.
Low's pain in osteochondrosis have the following characteristics:
1) Rimed pain.It is secondary, and proceeds according to the type of neuralgia, when the swollen nervous spine very “violently” reacts to a concussion.
The pain is sharp, sudden, shooting, piercing the lower back, possibly giving up.The pain appears and instantly intensifies, so it is called “lumbago”, or “background”.It is such a “shutter” that makes a person “stand up to a naracan”, since any movement leads to increased pain.
In addition, the pain intensifies at the slightest cough, sneezing, straining, laughter - any situation in which a swollen spine shakes.
In the event that the spine is part of the sciatic nerve, the pain “shoots” through the buttock into the popliteal fossa and below, and this is called “lumbar -algia”.
2) muscle pain.Near the nervous spine are large muscle massifs.Often, in the spring and autumn they “stand up”, and they swell themselves, become dense.The venous outflow is difficult in them, and they themselves are a source of pain.
This pain is aching, constant, and not so harsh.It, on the contrary, intensifies not only with a sharp movement, but also with a prolonged one in a monotonous position (deterioration of blood supply).
- Sometimes such myofascial syndrome occurs after exacerbation of protrusion or hernia, when a sharp “hook” of hernia “massages” the muscles and ligaments for a long time.
3) motor disorders.Since the disk can squeeze not only a sensitive, but also a motor spine, it is possible to develop peripheral paresis, or even paralysis.With different levels of damage, the appearance of weakness in the legs is possible (for example, weakness when climbing the stairs on the one hand), weakness in the foot, which leads to impaired gait.
There is muscle hypotrophy, one leg is “losing weight”.Such a purely motor, painless disorder is rare, and, remaining unnoticed, can lead to disability.
4) sensitive violations.They arise along with pain, exist often even after the end of pain, instead of pain.They are manifested by numbness, a decrease in the sensitivity of the skin of the legs by the type of “stripes”, in the form of vertical stripes, a sense of “crawling goosebumps” in the fingers and feet.
- Sometimes, with damage to vegetative fibers, symptoms are combined with hyperhidrosis, skin cooling, hair growth and nails.
These are the most general signs of complicated lumbar osteochondrosis existing in the lumbar region.There are separate syndromes, for example, damage to the external skin of the thigh, or damage to the horse tail, epiconus, pure radiculitis or pear -shaped muscle syndrome - but even their brief description will take too much time.
For patients, the above is enough, the main signs to sign up for a neurologist.How can you "remove the exacerbation with your own hands"?How to treat lumbar osteochondrosis of the house?
What to do during exacerbation of lumbar osteochondrosis?
The basis of all treatment is etiotropic therapy (elimination of the cause), and pathogenetic treatment (affecting the mechanisms of the disease).Symptomatic therapy adjoins him.
With vertebrogenous pains (caused by problems in the spine), things are like this:
- The elimination of the cause is the elimination of pressure by protrusion, a hernia, or a spasmoded muscle on a nerve root;
- The impact on mechanisms is the elimination of muscle spasm, the restoration of the venous outflow in the muscles, the removal of the edema of the nervous spine, and the fight against inflammation;
- The elimination of symptoms (the fight against pain, numbness, limitation of mobility) is carried out by returning to paragraph No. 2, since removal of edema and inflammation, for example, will return mobility and relieve pain.
Getting rid of protrusion and hernia
As a rule, he does not begin to treat acute back pain.Almost always at first they stop the pain syndrome, then, after the massage and treatment sessions of the manual therapist, all symptoms go away, and the operation is not required.
The question of surgical intervention arises with the progression of weakness in the foot, and with severe, unconscious pain within 2 months.In addition, the operation is required when compressing the central channel at high levels in which the spinal cord is located, or the “horse tail”.
Treatment of lumbar osteochondrosis, drugs
The treatment of lumbar osteochondrosis and its complications provides for the following measures.In the sharp phase (first day - two):
- In order to reduce muscle edema and spine, a sleepless diet is indicated, and the limitation of the amount of fluid used.You can even give a tablet of a slight diuretic drug that saves potassium.
- The wearing of a half -rigid orthopedic corset is shown, which saves the muscles from excessive movement.
- From the first days, the rubbing ointments containing NSAIDs, the application of plasters, for example, “pepper”, is shown.
- You can’t warm your back into the sharp phase.With increasing inflammation, edema increases.Therefore, all sorts of heating pads are prohibited.You can warm, taking your own warmth (wool belt, warming ointments), which are not added from the outside, but, on the contrary, is taken out of the depths.
- In the acute phase for osteochondrosis of the lumbar region, short -term treatment with intramuscular "injections" of the NSAI and muscle relaxants can be carried out.This will help stop the edema of nervous tissue, eliminate inflammation, and normalize muscle tone.
In the subacute period, after overcoming maximum pain, “injections” should no longer be taken, and attention should be paid to restorative means, for example, modern vitamin preparations of group “B”.They effectively restore impaired sensitivity, reduce numbness and paresthesia.
Physiotherapeutic measures continue, the time comes for conducting exercise therapy for osteochondrosis of the lumbar spine.Its task is to normalize the blood circulation and muscle tone, when edema and inflammation have already retreated, and muscle spasm was not yet fully resolved.
Exercises for lumbar osteochondrosis of the spine must be carried out after a light common warm -up, on the "warm -up muscles".
The main therapeutic factor is movement, not the degree of muscle contraction.Therefore, in order to avoid relapse, the use of burdens is not allowed, a gymnastic rug and a gymnastic stick are used.With their help, you can effectively restore the volume of movements.
The rubbing of ointments, the use of the Ipllicator Kuznetsov continues.Swimming, underwater massage, Sharko shower are shown.It is in the stage of damped exacerbation that drugs for home magnetotherapy and physiotherapy are shown.
Typically, treatment takes no more than a week, but in some cases, osteochondrosis can manifest itself with such dangerous symptoms that the operation may be needed, and urgent.
Complications of lumbar spine osteochondrosis
It is, first of all, about the condition when the hernia of the disk became an independent fragment, and, having penetrated the central channel, formed a free sequestration.There, it can squeeze the nerves of the horse tail, and it can suddenly (right in the gym, after an episode of acute pain) develop sharp weakness, or paralysis in the legs, numbness of the perineum.
After a few minutes, brutal pain in the legs appear, and then - a reflex delay in urine, or the appearance of incontinence, develops, impotence develops.This arose of the horse tail syndrome, as a complication of a disk hernia.In this case, urgent intervention, sequestral removal, and restoration of the function of the nerves of the horse tail with their decompression are required.
However, most often, other complications arise.With age, multiple hernias and protrusion occur, osteoporosis of the vertebrae appears, and mobility simply decreases and the risk of acute back pain increases.Such patients are sure to “take sick leave” a couple of times a year, and are often treated in sanatoriums.
Forecast of treatment
Osteochondrosis of the lumbar spine, the symptoms and treatment of which we dismantled higher, as we understood for ourselves, is for the most part not at all a disease, but simply by a manifestation of inevitable aging and premature "shrinkage" of intervertebral discs.
Can humanity be completely spared from lumbar osteochondrosis?This answer can be answered in the affirmative, but then we will have to master a different style of movement: all our lives to go on all fours, or, like ichtyander, float into the depths of the ocean, constantly moving in the water from childhood.It is then that the axial, static load on the intervertebral discs will disappear, and with it the signs of “chondrosis” will disappear.But another problem will arise: in water, such a powerful design will become simply unnecessary, and will begin to change until it disappears, or will not decrease significantly.
As for the personal, individual forecast for osteochondrosis, it all depends on the time when a person "decided to take up the mind."If by this time there is no pronounced destruction of the intervertebral discs, protrusions, hernias and deformations, then, subject to a healthy lifestyle and hygiene, physical activity can not be known to the very age of the back of the lower back.
In the same case, when there is already a “hot point” in the area of the lumbar region, for example, in the form of a hernia, which periodically squeezes the nervous spine, then a person needs to especially take care of awkward turns, physical exertion, improper lifting of severity and seasonal hypothermia, which usually cause an exacerbation of osteochondrosis of the spine.