Lumbar osteochondrosis

Lumbar osteochondrosis is a chronic disease that develops as a result of a degenerative-divophical process on intervertebral discs.The disease is generalized and affects people from 25 to 40 years.

According to back pain statistics, at least once in his life every second adult is experiencing, while in 95% of cases they are due to the spine osteochondrosis.

Patients with a severe course of lumbar osteochondrosis, with persistent pain and other manifestations are recognized as temporarily disabled.If within four months its condition does not improve, the problem of establishing a disability group is solved.

Lumbar osteochondrosis is a serious medical and social problem, since the disease mainly affects people of the earliest working age, and also in the absence of treatment, it can cause the formation of intervertebral disco.

Causes and Risk Factors

The factors that predispose to the development of lumbar osteochondrosis are:

• abnormalities of the structure of the column;
• Lumbalization is a congenital pathology of the column, characterized by the separation of the sacrum of the first vertebra and its transformation into the sixth (additional) lumbar (additional);
• Sacralization is an innate pathology, in which the fifth lumbar vertebra feeds with the sacrum;
• the asymmetric location of the joint cracks of the intervertebral joints;
• pathological narrowing of the spinal channel;
• Reflected spondogenic pains (somatic and muscles);
• obesity;
• sedentary lifestyle;
• prolonged exposure to vibration;
• systematic physical tension;
• smoking.

Adverse statusing loads combined with one or more risk factors lead to a change in the physiological properties of the core of the jacket of a fibrous disc, playing an absorbent paper of shock and providing the mobility of the spinal spinal column.The basis of this process is the depolymerization of polysaccharides, which leads to the loss of moisture with a fabric of the jet nucleus.As a result, the core of the jacket, and with it, the fibrous album loses its elastic properties.More mechanical loads cause the protuberance of the fibrous ring that has lost elasticity.This phenomenon is called protrusion.The cracks appear in the fibrous nucleus, through which the fragments of the jacket nucleus fall (prolapse, hernia of the intervertebral disc).

A long compression of the nerve roots that innervate certain organs of the abdominal cavity over time leads to a deterioration in its operation.

The instability of the spinal segment is accompanied by reactive changes in the bodies of the adjacent vertebrae, the intervertebral joints and the osteoarthritis of concomitant spondyl.A significant muscle contraction, for example, at the bottom of physical activity, leads to a change in the backbone and the violation of nerve roots with the development of root syndrome.

Osteophytes can be another cause of pain and neurological symptoms with lumbar osteochondrosis: bone growth in processes and bodies of vertebrae that cause myelopathy of Royshold or compression syndrome (compression of the spinal cord).

Disease forms

Depending on which structures are in the pathological process, lumbar osteochondrosis is clinically manifested by the following syndromes:

• Reflection- Lumbalgia, Lumboichachalia, Lumbago;Develop in the context of the reflex surge of the muscles of the back;
• compression (spinal, vascular, root)- Its development is leading to compression (compression) of the spinal cord, blood vessels or nerve roots.The examples are lumbosacra radiculitis, radicalize.

Lumbar osteochondrosic symptoms

With lumbar osteochondrosis, symptoms are determined by which structures are attracted to the pathological process.

Lumbago occurs under the influence of hypothermia or physical overwrite, and sometimes without apparent reason.The pain suddenly appears and is shooting.It intensifies when sneezing, coughing, body turns, physical effort, seat, standing, walking.In the liar position, pain is significantly weakened.Sensitivity and reflexes are preserved, the volume of movements in the lumbar region is reduced.

On palpation, they observe:

• pain in the lumbar region;
• paravertebral muscles spasm;
• The flattening of lumbar lordosis, which in many cases is combined with scoliosis.

The voltage syndrome of the nerve roots with lumbar is negative.When raising a straight leg, patients point to the increase in lower back pain, and not their appearance in an elongated lower limb.

Often, with lumbar osteochondrosis, there is a repeated occurrence of pain attacks, which becomes increasingly intense and long.

With Lumbalia, the clinical image resembles a lumbago, however, an increase in pain intensity occurs in a few days.

In the form of lumbar, patients complain of pain in the lower back, which radiates in one or both lower extremities.The pain extends over the buttocks and the back of the thigh and never reaches the feet.

Vasomotor disorders are characteristic of lumbar storage:

• Changes in the temperature and color of the skin of the lower extremities;
• sensation of heat or cold;
• Blood supply violation.

The development of lumbar compression syndromes is clinically manifested by the following symptoms:

• Dermatomic Gipalgesia;
• shooting pain;
• weakening or complete loss of deep reflexes;
• Peripheral pairsis.

With compression syndromes, pain intensifies by bowing the body, sneezing and coughing.

Diagnosis

The diagnosis of lumbar osteochondrosis is carried out on the basis of the clinical image of the disease, the laboratory and the instrumental research methods.

In blood tests in the context of lumbar osteochondrosis, it can be observed:

• decrease in calcium concentration;
• increase in the ESR;
• Increasing the level of alkaline phosphatase.

In the diagnosis of lumbar osteochondrosis, the radiological examination of the spine is of great importance.

A long compression of the nerve roots that innervate certain organs of the abdominal cavity over time leads to a deterioration in its operation.

The X -ray characteristics that confirm the diagnosis are:

• change in the configuration of the affected segment;
• Pseudopondylastez (change of related vertebral bodies);
• deformation of the closing plates;
• flattening disk;
• The unequal height of the intervertebral disc (spacer symptom), which is associated with asymmetric muscle tone.

Also in the diagnosis of lumbar osteochondrosis in the presence of indications:

• Myelography, calculated or magnetic tomography: they are necessary for persistent symptoms, the development of neurological deficiency;
• Gammography (the study of the accumulation of a phosphorus bone system, a molten technology-99) is performed in case of suspicion of a tumor or infectious process, a spinal injury.

The differential diagnosis of lumbar osteochondrosis is carried out with the following diseases:

• Spondylolistz;
• Deormonal spondylopathy;
• ankylosing spondylitis (spondel ankylosing);
• Infectious processes (inflammation of discs, column osteomyelitis);
• non -plastic processes (primary column tumor or its metastatic lesions);
• rheumatoid arthritis;
• deforming the osteoarthrosis of the hip joint;
• Reflected pains (internal organ diseases and large blood vessels).

Lumbar osteochondrosis treatment

With lumbar osteochondrosis, they usually adhere to the following treatment tactics:

• Bed rest for 2-3 days;
• traction of the column affected segment;
• strengthen the muscles of the back and abdominal press (the creation of the muscular corset called);
• Impact on pathological and myofascial and myotonic processes.

Lumbago occurs under the influence of hypothermia or physical overwrite, and sometimes without apparent reason.

In most cases, the conservative treatment of lumbar osteochondrosis is performed, including the following measures:

• muscle infiltration with a solution of local anesthetics;
• taking non -steroidal anti -inflammatory drugs;
• Reception of desensitizing agents;
• vitamin therapy;
• Reception of tranquilizers and antidepressants;
• Manual therapy, massage;
• Physiotherapy Physical Education;
• acupuncture;
• Postisometric relaxation.

The absolute indications for the surgical treatment of lumbar osteochondrosis are:

• acute or subacute compression of the spinal cord;
• The development of the horse tail syndrome, characterized by the deteriorated function of pelvic organs, sensitive and motor disorders.

Medical Gymnastics for Lumbar Osteochondrosis

In the complex treatment of lumbar osteochondrosis, an important role belongs to physiotherapy exercises.The regular classes allow normalizing the muscle tone of the paravertebral muscles, improving the metabolic processes in the tissues affected by the pathological process and, in addition to forming a well -developed muscle corset, which can maintain the column in the correct position, eliminate excessive static loads of it.

So that gymnastics with lumbar osteochondrosis is the greatest effect to adhere to the following principles:

• regularity of classes;
• gradual increase in the intensity of physical effort;
• Avoid excess work during lesson.

Physical education must participate in the leadership of an experienced instructor, which will select the most effective exercises for a particular patient and control the correction of its implementation.

According to back pain statistics, at least once in his life every second adult is experiencing, while in 95% of cases they are due to the spine osteochondrosis.

In addition to classes with an instructor, a morning gymnastics complex must perform daily, which includes special exercises with lumbar osteochondrosis.

1. Relaxation and contractions of abdominal muscles.The initial position is standing, the legs are separated by the shoulder, the hands of the body are low.Make a soft breathing, relaxing the muscles of the anterior abdominal wall.During exhalation, draw in yourself as much as possible, striving the press muscles.Exercise should be repeated before the appearance of fatigue of light.
2. Movement of the head with the flexion of the spine.The initial position of the knees, resting on the floor outside the back, the back is straight.Slowly he raises his head and bends at the back.To stay in this position for a few seconds, and then return gently to its original position.Repeat at least 10-12 times.
3. "Pendulum".The initial position found in the back, the arms along the body, the legs are folded at right angles in the knee and hip joints.Turn your legs to the right and left with the pendulum -shaped movements, trying to get the floor.At the same time, shoulder blades cannot be started from the floor.
4. "Boat".The initial position of sleeping on the stomach, the hands extend forward.Throw from the top of the body and legs on the floor, bending in the back.Stay in this position for 5-6 seconds and slowly return to the initial position.Perform 10 times.

Possible consequences and complications

The main complications of lumbar osteochondros are:

• the formation of intervertebral hernia;
• Vegetasular dystonia;
• Spondylolis, Spondylolistz;
• osteophosis;
• spondilartrosis;
• The stenosis of the spinal channel, which leads to the compression of the spinal cord and is able to cause persistent loss of work capacity and reduce the quality of life.

A long compression of the nerve roots that innervate certain organs of the abdominal cavity over time leads to a deterioration in its operation.As a result, patients have intestinal dysfunctions (constipation, diarrhea, flatulence) and pelvic organs (urination disorders, erectile dysfunction, frigidity, infertility).

Forecast

Pain syndrome for lumbar osteochondrosis proceeds in the form of remissions and exacerbations.Lumbago lasts 10-15 days, after which the patient's condition improves, pain decreases.Secondary diseases can interfere with a favorable result.Often, with lumbar osteochondrosis, there is a repeated occurrence of pain attacks, which becomes increasingly intense and long.

In the complex treatment of lumbar osteochondrosis, an important role belongs to physiotherapy exercises.

Patients with a severe course of lumbar osteochondrosis, with persistent pain and other manifestations are recognized as temporarily disabled.If within four months its condition does not improve, the problem of establishing a disability group is solved.

Prevention

The prevention of the development of the spine osteochondrosis is the following measures:

• Smoking rejection;
• standardization of body weight;
• Improvement of the general physical condition, active lifestyle;
• Avoid provocative conditions (weightlifting, acute movements, turns, inclinations).