Lumbar osteochondrosis is a chronic disease that develops as a result of the degenerative-dystrophic process in the intervertebral disc.The disease is extensive and affects most cases of 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 their cases due to spinal osteochondrosis.
Patients with severe lumbar osteochondrosis, with persistent pain and other manifestations are recognized as temporary disabilities.If within four months their situation does not improve, the issue of the establishment of a defect group is resolved.
Lumbar osteochondrosis is a serious medical and social problem, as the disease affects the most working people, and in addition, if there is no treatment, it can cause the formation of intervertebral disc hernia.
Cause and risk factors
Factors exposed to the development of lumbar osteochondrosis are:
- spinal structure abnormalities;
- Lebralization is a congenital pathology of the spinal cord, characterized by the separation of the first vertebral sacrum and its transformation in the sixth (additional) lumbar;
- Sacralization is a natural pathology, in which the fifth lumbar vertebra is fed with sacrum;
- asymmetric location of the intervertebral joint articular cracks;
- narrowing of the pathology of the spinal cord;
- reflect spondiogenic pain (somatic and muscle);
- obesity;
- SEDENTARI LIFE;
- prolonged exposure to vibration;
- systematic physical tension;
- smoke.
Bad statodynamic load combined with one or more risk factors leads to changes in the physiological properties of fibrous disc jackets, playing a role that absorbs shock and provides spinal column mobility.The basis of this process is the depolymeric polysaccharides, which leads to the loss of moisture with the jet nucleus.As a result, the nucleus of the jacket, and thus, the fibrous disc loses their elastic properties.Further mechanical loads trigger the promotion of fibrous rings that have lost elasticity.This phenomenon is called protrusion.Cracks appear on the fibrous core, where the jacket nucleus fragments (prolapse, intervertebral disc hernia) fall.
Long compression of the nerve root that intensifies certain organs from the abdominal cavity over time leads to deterioration in their function.
The instability of the spinal segment is accompanied by reactive changes in the body -adjacent vertebral, intervertebral joints, and spondil arthrosis.Significant muscle contraction, for example, against the background of physical activity, leads to the transition of the vertebral body and the infringement of the nerve root with the development of radicular syndrome.
Osteophytes can be another cause of pain and neurological symptoms with lumbar osteochondrosis - grow bone in the process and body of the vertebra that causes royshold syndrome or compression myelopathy (spinal cord compression).
A form of a disease
Depending on which structure is drawn into the pathological process, lumbar osteochondrosis is clinically indicated by the following syndrome:
- Reflex- Lumbalgia, Lumboichachalia, Lumbago;develop background of overvoltage back muscle reflex;
- compression (spine, vascular, radical)- Their development leads to compression (compression) of the spinal cord, blood vessels or nerve roots.Examples are lumbosacral radiculitis, radiculoichemia.
Symptoms of lumbar osteochondrosis
With lumbar osteochondrosis, symptoms are determined by the structure that is drawn into the pathological process.
Lumbago occurs under the influence of hypothermia or physical overvoltage, and sometimes for no apparent reason.The pain appeared suddenly and shot.It increases when sneezing, coughing, body changes, hard work, seating, standing, walking.In a lying position, the pain is very weak.Sensitivity and reflexes are preserved, the amount of movement in the lumbar region is reduced.
On palpation, they observe:
- pain in the lumbar region;
- paravertebral muscle spasms;
- Lumbar lordosis medicine, which in many cases is combined with scoliosis.
Nerve root tension syndrome with lumbar is negative.When raising the legs straight, the patient recorded an increase in pain in the lower back, rather than their appearance in the lower back.
Often, with lumbar osteochondrosis, there are repeated attacks -repeated attacks, which each becomes more intense and longer.
With lumbalia, the clinical picture resembles lumbago, however, increased pain intensity occurs within a few days.
In lumbar form, the patient complains of pain in the lower back, which emits one or both lower limbs.The pain spread to the back and back of the thigh and never reached the foot.
Vasomotor disruption is a lumbar characteristic character -
- changes in temperature and color of lower skin;
- heat or well -being;
- Infringement of blood supply.
The development of clinically lumbar compression syndrome is indicated by the following symptoms:
- Gipalgesia dermatomics;
- shooting pain;
- weakness or complete loss of reflexes in;
- Peripheral paresis.
With compression syndrome, the pain is increasing when tilted, sneezing and coughing.
Diagnostics
The diagnosis of lumbar osteochondrosis is performed based on the clinical picture of the disease, laboratory and instrumental research methods.
In blood tests against the background of lumbar osteochondrosis, it can be observed:
- reduction in calcium concentration;
- increase in ESR;
- Increase the level of alkaline phosphatase.
In the diagnosis of lumbar osteochondrosis, spinal radiological examination is given very important.
The long compression of the nerve root that intensifies certain organs from the abdominal cavity over time leads to deterioration in their function.
The feature -The feature of X -ray that confirms the diagnosis is:
- changes in the configuration of the affected segment;
- pseudospondylastez (relevant vertebral body transition);
- deformation of the cover plate;
- leveling the intervertebral disc;
- The height of the uneven intervertebral disc (spacer symptoms), which is associated with asymmetric muscle tone.
Also in the diagnosis of lumbar osteochondrosis with the presence of indicators used:
- Myelography, computation of tomography of rejection or magnet - is required for persistent symptoms, development of neurological deficiency;
- Scintigraphy (a study of phosphorus bone system collection, liquid-99 technology)-which is done in cases of suspected tumors or infectious processes, spinal injuries.
Diagnosis of differential lumbar osteochondrosis is performed with the following disease:
- Spondylolistz;
- Spondylopathy Damuan;
- ankylosing spondylitis (ankylosing spondylitis);
- Infectious processes (disc inflammation, spinal osteomyelitis);
- The neoplastic process (the main tumor of the spine or its metastatic lesions);
- rheumatoid arthritis;
- alter the osteoarthrosis of the hip joint;
- Reflected pain (internal organs and large blood vessels).
Lumbar osteochondrosis treatment
With lumbar osteochondrosis, they usually adhere to the following treatment tactics:
- rest for 2-3 days;
- attraction of segment affected by the spine;
- strengthen the muscles -The back and stomach newspaper (the creation of a coordinated muscle corset);
- Effects on myofascial and pathological myotonic processes.
Lumbago occurs under the influence of hypothermia or physical overvoltage, and sometimes for no apparent reason.
In most cases, conservative treatment of lumbar osteochondrosis is performed, including the following steps:
- muscle infiltration with local anesthetic solution;
- taking anti -medications -non -ssteroids;
- Acceptance of Desensitizing Agent;
- vitamin therapy;
- acceptance of sedatives and antidepressants;
- Manual therapy, massage;
- Physiotherapy physical education;
- acupuncture;
- Postisometric relaxation.
The absolute indication of the treatment of lumbar osteochondrosis is:
- acute compression or subacute of spinal cord;
- The development of horse tail syndrome, characterized by the function of pelvic organs, sensitive and motor disorders.
Medical gymnastics for lumbar osteochondrosis
In the treatment of complex lumbar osteochondrosis, an important role belongs to physiotherapy training.The ordinary class allows to normalize paravertebral muscle tone, improve the metabolic processes in the tissues affected by the pathological process, and in addition to forming a well -developed muscle corset, which can keep the spine in the right position, removing excess static load from it.
In order for gymnastics with lumbar osteochondrosis to have the biggest impact to adhere to the following principles:
- Classroom ruling;
- gradually improvement in physical work intensity;
- Avoid hard work during the lesson.
Physical education should be involved in the leadership of experienced educators, who will choose the most effective training for specific patients and control the accuracy of their implementation.
According to back pain statistics, at least once in his life every second adult is experiencing, while in 95% of their cases due to spinal osteochondrosis.
In addition to classes with instructors, you should perform a morning gymnastics complex, which includes special training with lumbar osteochondrosis.
- Relax and contraction of the abdominal muscles.The starting position of the stand, the legs are the shoulders separate, the body's hand is lowered.Make a smooth, relaxing muscle -The anterior abdominal wall.During breathing, draw as much as possible, relaxing the newspaper muscles.This exercise should be repeated before the appearance of light fatigue.
- Movement of the head with the bending of the spinal cord.The starting position of the knee, rest on the floor out of the back, back straight.Slowly raise the head and bend behind.For a long time in this position for a few seconds, and then smoothly return to its original position.Repeat at least 10-12 times.
- "Pendulum".The starting position is located on the back, the arms along the body, the legs are bent at the right angle of the knee and hip joints.Turn the feet to the right and left with the movement of the pendulum, trying to get the floor.At the same time, the shoulder blade cannot be torn from the floor.
- "Boat".The starting position lies in the stomach, the hands are extended forward.Remove the upper body and feet from the floor, bending behind.To linger in this position for 5-6 seconds and slowly return to the starting position.Do 10 times.
Possible consequences and complications
The main complications of lumbar osteochondrosis are:
- the formation of intervertebral hernia;
- vegetable dystonia;
- Spondylolis, spondylolistz;
- osteophytosis;
- Spondylarthrosis;
- The stenosis of the spinal cord, which leads to spinal cord compression and can lead to continuous loss of work capacity and reduces the quality of life.
Long compression of the nerve root that intensifies certain organs from the abdominal cavity over time leads to deterioration in their function.As a result, the patient has intestinal dysfunction (constipation, diarrhea, bloating) and pelvic organs (urinary tract disorders, erectile dysfunction, frigidity, infertility).
Prophesy
The pain syndrome for lumbar osteochondrosis runs in the form of remission and severity.Lumbago lasts for 10-15 days, after the patient's condition improves, pain subsides.Apartic secondary disease can interfere with good results.Often, with lumbar osteochondrosis, there are repeated attacks -repeated attacks, which each becomes more intense and longer.
In the treatment of complex lumbar osteochondrosis, an important role belongs to physiotherapy training.
Patients with severe lumbar osteochondrosis, with persistent pain and other manifestations are recognized as temporary disabilities.If within four months their situation does not improve, the issue of the establishment of a defect group is resolved.
Prevention
Prevention of the development of spinal osteochondrosis is the following steps:
- The refusal of smoking;
- weight normalization;
- increased general physical condition, active lifestyle;
- Avoid provoking conditions (weight lifting, sharp movements, turns, tendencies).