Osteochondrosis is the worst form of degenerative wounds of the spine, which is based on the defeat of the intervertebral disc, with deformation adjacent to different ligaments.
One of the most common forms of osteochondrosis is osteochondrosis of the lumbar region, or, more precisely, lumbosacral spine.For many - both men and women - are familiar with back pain, sacrum, lower leg, caused by a variety of lumbar osteochondrosis and its complications.Among the causes of defects and temporary defects, the disease occupies one of the first place.
The course of the disease is chronic, usually with a period of enlargement.Often, enlargement of lumbar lumbar lumbar lifts and heavy transplantation, hypothermia, stress, and provoked injury.
Lumbar spinal osteochondrosis - cause, mechanism of occurrence and development
There is no obscure cause of osteochondrosis, the disease is considered polyfaver.The most popular theory is, according to the cause of spinal osteochondrosis is a constant constant of the muscle -otot or muscle hypotension, nonphysiological muscle tension, leading to degen -produced vertebra.osteochondrosis.
Causes of premature aging intervertebral discs can also be endocrine and metabolic disorders, hereditary tendencies to the development of osteochondrosis, autoimmune disorders, and microtrauma.The negative role of visceral, that is, in relation to the internal organs, pathology in the development of spinal osteochondrosis, has also been proven.An important role in the development of the disease is bad offspring.The contribution of hereditary factors to the appearance of lumbar osteochondrosis is about 60%, the rest refers to the factors of adverse external influence on the spine.
Factors that contribute to the development of osteochondrosis in the lumbar and other parts of the spine are huge.Their main: Improper posture, hypodynamia, muscle overvoltage in the lumbar region due to continuous weight or overload, hormone restructuring, endocrine and somatic disease, violation of normal blood supply to spinal tissue, emotional stress, related age changes, under the influence of these factors, dehydration,Bone, and disc - the hernia gradually increases.
The most obvious causes of lumbar osteochondrosis are most often considered as inactive lifestyle and back injuries.Therefore, risk groups mainly include people whose professions are directly related to the load on the back.These are a variety of professions - sellers and servers, surgeons and teachers - all who have to spend most of the work time.Risk groups include builders and movers, as well as athletes who, who, in the nature of the activity, have a large burden on the spine.In addition, drivers, various office workers, programmers - that is, those with the most inactive work, and those suffering from hypodynamia, suffering from lumbar osteochondrosis.
Symptoms of lumbar spinal osteochondrosis
OnLumbar osteochondrosisThe painful sensation of various properties is possible.This can be a pain that occurs with prolonged chairs or after sleep, as well as sharp shooting, causing the most uncomfortable pose and does not allow the opportunity to straighten.The pain is pinned by the nerve root, the nerve irritation of the spinal column, edema and muscle irritation and ligaments located in the lumbar spinal preservation zone.
Pain syndrome can be caused by compression of radicemic structure (radiculopathy), spinal cord compression (compression myelopathy), damage to the spinal cord due to impaired blood supply, narrowing (stenosis) of arteries and supply veins (compression-vascular myelohemia).
The compression reasons are: the highlights and hernia of the intervertebral disc, the spondylolistz (the vertebral slippers forward in relation to the base), the growth of osteophytes and the cartilaginus tissue in the vertebral segment.As a resultOsteochondrosis of the lumbar areaThe spine leads to narrowing of the canal in which the cerebrospinal nerve or vascular structure passes, and under certain conditions (awkward movements, physical activity, unsuccessful body turn, etc.), compression (squeeze) may occur.Compression of the nerve structure leads to various pain syndrome, muscle cramps.Compression of the blood vessels causes a violation of blood supply - the ischemia of the organs that feed on the vessels or arteries begins.
Clinical syndrome of lumbar spinal osteochondrosis
The clinical picture for lumbar osteochondrosis is determined by the complex of vertebral symptoms (static and dynamic lumbar spinal dynamics) and controlled symptoms, which are understood as a violation of the function of neurological and vascular structures in the spinal lumbosacral region.
Lumbar osteochondrosis syndrome
With lumbar osteochondrosis, vertebral syndrome is characterized by the following symptom complex:
- Violations of the configuration of the functional segment of the spinal cord: an increase or (less frequently) an increase in lordosis, scoliosis or mastery of the masters;
- violations of mobility in the lumbar region, decrease in the volume of movement, muscle-tonic imbalance caused by the tension of both the multi-human and shallow muscle;
- Local pain and pain with active and passive movements, which causes tonic muscle tension;
- violations of the spring-motor function of both intervertebral discs and, in general, the vertebral-motor segment;
- Local pain (increased sensitivity) of the bone-ligament structure of the spinal cord in the affected area (pain during palpation, local vertebral pain syndrome and/or vertebral).
It is important to note that with the lumbar department osteochondrosis, vertebral pathology is always observed.The presence of signs of myelopathy, radiculopathy and myeloradiculopathy without clear clinical and morphological signs of vertebral syndrome require, as a rule, more patient examination for major damage ("non -sorester") in the nervous system.
Extrovertebral syndrome (reflex and compression) for lumbar spinal osteochondrosis
Extrovertebral syndrome is divided into two large groups: reflex and compression.
Reflex syndromeThey precede compression and are caused by irritation of the nerve root receptors that appear from the spinal cord through the intervertebral hole.Irritation can be caused by intervertebral hernia, bone growth, and vascular disorders (edema, blood circulation), and inflammation.In some cases, this leads to intensive pain, which occurs not only in the country, but also in the course of the nerves far from the area of irritation -"reflected pain", reflecting pain can be short and acute ("shift") or long stupid.In damaged nerve preservation zones, vegetative disorders (burning, goosebumps, impaired sensitivity) are possible.Myofascial pain is possible - muscle cramps, leading to limiting movements.
Reflex syndrome includes lumbago ("shift") in the development of acute disease and lumbargia with subacute or chronic courses.
Compression syndrome is a syndrome that is caused by compression, nerve violations, blood vessels, spinal cord in the lumbar spinal segment.Compression syndrome for lumbosacral department osteochondrosis is divided into radical and vascular-brown.The special case of compression syndrome is myelopathy - a spinal cord.
Remedy syndrome (radiculopathy) is usually caused by disk protrusions, causing cerebrospinal root violations.Radicular symptoms that arise in this case correspond to the level of the affected vertebra segment.Often, the L4-S1 root is affected.
Vascular-brown neurological disorders are caused by compression of the hernia in the spine and root artery that passes with it.At the same time, "Ishias paralyzed" can develop disaster, characterized by peripheral paresis or paralysis of the muscle of the foot.In such cases, the appearance of motor disorders is accompanied by loss of pain.
Even worse neurological manifestations due to infarction of blood supply to the spinal cord due to damage to the radicular artery.At the same time, chronic disruption myelopathy develops, usually at the stage of lumbarening of the spinal cord.
The most unprofitable version of lumbar vertical radical syndrome is the compression of the "horse tail" - a coordinated caudal syndrome.Often, it is caused by a medinal hernia that falls from the disc, which squeezes all the roots at the affected segment.
What is lumbar spinal osteochondrosis?What is the gesture?How to treat lumbar osteochondrosis?
Clinical classification of osteochondrosis of the lumbar region.Osteochondrosis degree
Lumbar osteochondrosis classification by degree is used for the systematic features of the clinical manifestation of the disease.This classification systematically describes the symptoms of the disease and starts from the time the patient is in pain.
1 degree osteochondrosis
It occurs when an intervertebral disc caused by a sharp movement or overvoltage occurs.It is characterized by the pain that is suddenly, in the spine of the feeling of the electric current, the muscles -the tense reflexive muscles.
2 degrees osteochondrosis
The second degree can be manifested in the form of intervertebral symptoms and spinal instability.Chronic pain increases at load.Alternative forgiveness and alternative severity.The cervical region is characterized by pain in the neck, increases after a long stay in one position, headache, pain in the hands, shoulder pain, periodic discomfort or finger numbness.For the lumbar region - lower back pain, pain in the gluteal region, periodic pain in the sacrum, frequent fatigue in the foot.
3 degrees osteochondrosis
It manifests itself in the form of intervertebral disc hernia symptoms (pain along the affected nerve, numbness of the arm or leg, changes in gait, headache) or symptoms far from intervertebral hernia (in the spine: heart rhythm violations, difficulty breathing;
4 degrees osteochondrosis
It is generally accepted that the fourth stage of osteochondrosis begins at the time when the hernia is no longer real, the manifestation of the disease can decrease, but the symptoms of spinal instability, slipping or twisting the vertebra, or their complete fixation are still relative to each other.The manifestation of the growth of the vertebral body (osteophytes) can join them, which can also squeeze the spinal cord or overlap the spinal canal (secondary stenosis of the spinal cord) and squeeze the spinal cord (spinal cord ischemia).In addition, the fourth stage includes surgical intervention if the hernia is removed immediately (various types of conservation, paresis, inflammation).
Lumbar spinal osteochondrosis treatment
With the first acute back pain, you should consult a doctor to establish a diagnosis to exclude kidney colic attacks, appendicitis, or other diseases that require emergency medical treatment.
If the cause of back pain is known, and this aggravates the lumbar spinal osteochondrosis, first of all, it is necessary to maximize the load on the spine.It is necessary to observe your sleep for 3 to 7 days - sometimes only this can reduce pain.But to speed up recovery, it needs to be correct, that is, effective, treatment.It should stimulate its own protective process and health in the human body.Treatment should take into account the localization of the lesion, the level of the disease, the condition of the body and its individual system.The surgical treatment of the disease is only indicated in severe cases.Often, various conservative methods of osteochondrosis are used.
Conservative treatment of lumbar osteochondrosis
Conservative treatment methods are, first of all, drug treatment.To reduce pain, as well as to reduce inflammation, which is often the cause of vertebral syndrome, anti -non -ssteroid (NSAIDs) drugs in the form of tablets or -in cases of acute -in the form of injections.Occasionally, after injection, analgesics, painful pain and not resumed even the duration of the medical material.This means that it is possible to break the demonic circle where pain leads to muscle cramps, and muscle tension, in turn, increases pain.However, if the pain lasts a long time, it is important to remember that NSAIDs usually have a variety of side effects and with prolonged use can lead to unwanted complications - a decrease in the number of leukocytes in the blood, complications of the gastrointestinal tract.
Often, sedative (calming) agents are prescribed to improve the general condition of the patient within 1-3 weeks, as well as small doses of antidepressants.With lumbar spinal osteochondrosis, if necessary, novocaine restrictions are produced.Recently, drugs of anticonvulsants began to be successfully used to relieve pain.
To reduce compression syndrome, manual therapy, traction treatment (spinal attraction) and in cases of specials - surgery.
When weakening the properties of ligaments and spinal consistency, it is recommended to use the setting device -corsets, collars, bandages, and more.And patients with spinal osteochondrosis are very important in the future to strengthen their own muscle corsets.
After removing acute symptoms, the task of making muscle setting first comes in the first place, and then stimulates the process of regeneration of the damaged structure.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use chondroprotectors (medicine to restore cartilage tissue).As well as medicines that improve blood vessels (angioprotectors), vitamins, especially group B, calcium preparations that improve bone tissue conditions.
For the treatment of spinal osteochondrosis, physiotherapy procedures are widely used.They reduce tissue and edema pain, improve blood circulation, and stimulate muscle fixation.The procedure can be combined, replace.Physiotherapy treatment methods such as:
- Darsonvalization of affected areas and affected limbs;
- electrophoresis;
- low laser radiation;
- ultrasound;
- exposure to magnetic fields;
- Thermal procedure.
In the sanatorium, mud, ozokokitik, paraffin applications, radon, sulfide, hydrogen sulfide, turpentine and other baths were successfully used;
Keep in mind that for the development of full regeneration, it takes a long time, in a favorable situation in the sixth month.Therefore, the treatment should be long.It should be carried out in a combination, that is, combined medicines with physiotherapy and physiotherapy training.