Osteochondrosis is the most serious form of degenerative lesion -Distophical of the column, which is based on the defeat of the pulpic nucleus of the intervertebral disc, with subsequent deformations of the body of the adjacent vertebrae, the intervertebral joints, the deterioration of the devices of the devices of the route of the route of the blood of the blood.
One of the most common ways of osteochondrosis is the osteochondrosis of the lumbar region, or, more precisely, of the lumbosacra column.For much, both men and women, are familiar with back pain in the lower back, the sacrum, the lower extremities, caused by various types of lumbar osteochondrosis and their complications.Among the reasons for disability and temporary disability, this disease occupies one of the first places.
The course of the disease is chronic, usually with periods of exacerbations.Very often, the exacerbations of osteochondrosis of the lumbar linema and the transfer of weights, hypothermia, stress and injuries are caused.
Lumbar column osteochondrosis: causes, mechanism of occurrence and development
There was no unequivocal cause of osteochondrosis, the disease is considered polypherve.The Most Popular Theory Is, According to Which the Cause of Osteochondrosis of the Spine Is The Constant Overwhelming of the Muscles or Hypotension of Muscles, Nonphysiological Muscle Tension, Which Leads to Overloading The Vertebral Segments, The Deterioration of Their of Their Blood Supply And, UltimatelyThe Degeneration of the Intervertebral Discs and Joints, The result of which is the result of which is the results.
The cause of premature aging of intervertebral discs can also be endocrine and metabolic disorders, a hereditary predisposition to the development of osteochondrosis, autoimmune disorders and microtrauma.The negative viscceral role has also been demonstrated, that is, related to the internal organs, in the development of the spine osteochondrosis.An important role in the development of the disease belongs to adverse inheritance.The contribution of hereditary factors to the appearance of lumbar osteochondrosis is approximately 60%, the rest refers to adverse external influence factors in the spine.
The factors that contribute to the development of osteochondrosis both in the lumbar and in other parts of the column are very numerous.The main one: inadequate posture, hypodinamia, muscle surge in the lumbar region as a result of the constant use of weights or an acute excessive load, hormonal restructuring, endocrine and somatic diseases, violation of the normal blood supply to the tissue of the spine, emotional stress, age changes, changes of poor nutrition.Under the influence of these factors on the structures of the spine, dehydration processes and circulatory disorders, osteoarthritis and subluxation in small joints, bone growth and discs - hernias are gradually increasing.
The most obvious causes of lumbar osteochondrosis are more frequently considered a sedentary lifestyle and a back injury.Therefore, the risk group mainly includes people whose profession is directly related to loads on the back.This is a wide range of professions: sellers and waiters, surgeons and teachers, all who are forced to spend most of the work time standing.The risk group includes builders and engines, as well as athletes that, which, in the nature of the activity, large loads arise in the spine.In addition, drivers, several office workers, programmers, that is, those who have the mostly sedentary work, and suffer from hypodinamia, suffer from osteochondrosis of lumbar.
Symptoms of the lumbar column osteochondrosis
InLumbar osteochondrosisThe painful sensations of various nature are possible.This can be painful pain that occurs with a prolonged seat or after sleep, as well as an acute shot, causing the most uncomfortable pose and without allowing the opportunity to straighten.The pain is pinched by the nerve roots, the irritation of the nerves of the spine, edema and irritation of the muscles and ligaments located in the innervation zone of the lumbar column.
The pain syndrome can be caused by the compression of the radiolymic structures (radicleopathy), the compression of the spinal cord (compression myelopathy), damage to the spinal cord due to the deteriorated blood supply due to the thrust, the narrowing (stenosis) of the arteries and the supply veins (honeyhelhemic for exular compression).
The reason for compression can be: protrusion and hernia of the intervertebral, spondylolist discs (sliding the vertebra forward in relation to the underlying), the growth of osteophytes and the cartilaginous tissue in the vertebral segment.As a resultOsteochondrosis of the lumbar regionThe column column leads to a narrowing of the channel through which the cerebrospinal nerves or vascular structures pass, and under certain conditions (uncomfortable movement, physical activity, a failed turn of the body, etc.), compression can occur (squeeze).The compression of nerve structures leads to several pain syndromes, muscle spasms.The compression of the blood vessels causes a violation of the blood supply: the ischemia of the organ that feeds this glass or artery begins.
Clinical Syndromes of Lumbar Column Osteochondrosis
The clinical image of lumbar osteochondrosis is determined by a complex of vertebral symptoms (a change in statistics and dynamics of the lumbar spine) and the escorted symptoms, which are understood as a violation of the function of neurological and vascular structures in the lumbosacal region of the column.
Vertebral syndromes of lumbar osteochondros
With lumbar osteochondrosis, vertebral syndrome is characterized by the following symptoms complex:
- Violation of the configuration of the functional-anatomical spinal segment: a flattening is observed or (less often) an increase in lordosis, scoliosis or lordoscoliosis;
- Violation of mobility in the lumbar region, a decrease in the volume of movements, the muscular tonic imbalance caused by the tension of the deep and superficial multi -human muscles;
- Local pain and pain with active and passive movements, which causes reflex tonic muscle tension;
- violation of the spring-motor functions of the intervertebral disc and, in general, the vertebral-motor segment;
- Local pain (increase in sensitivity) of bone ligament structures of the spine in the affected area (pain during palpation, vertebral pain syndrome and/or local vertebrosonal (regional)).
It is important to keep in mind that with the osteochondrosis of the lumbar department, vertebral pathologies are always observed.The presence of signs of myelopathy, radicleopathy and myloradiculopathy without obvious clinical and morphological signs of the vertebral syndrome requires, as a rule, a deeper examination of the patient for the primary damage ("non -sorestral") to the nervous system.
Outgoing syndromes (reflex and compression) for the osteochondrosis of the lumbar column
Extroven syndromes are divided into two large groups: reflection and compression.
Reflex syndromesThey precede compression and are caused by the irritation of the receptors of the nerves that emerge from the spinal channel through intervertebral holes.Irritation can be caused by intervertebral hernia, bone growth, as well as vascular disorders (edema, worsening of blood circulation) and inflammation.In some cases, this leads to intensive pain, which occurs not only locally, but also in the course of the nerve at a distance from the place of irritation, the pain of "reflected pain" called, can be short and sharp ("change") or stupid in the long term.In the damaged nerve innervation, vegetative disorders (ardor, chicken chicken, altered sensitivity) are possible.Myofasial pains are possible: muscle spasm, which leads to limiting movements.
Reflex syndromes include lumbago ("change") in acute development of disease and low back pain with a subagudo or chronic course.
Compression syndromes are syndromes that occur as a result of compression, nerve infraction, blood vessels, spinal cord in the area of lumbar spinal segments.Compression syndromes for osteochondrosis of the lumbosacro department are divided into root and vascular brown.A special case of compression syndrome is myelopathy: infraction of the spinal cord.
Remedy syndromes (radicalopathy) are generally due to the protuberances of the disc, which causes the infraction of the cerebrospinal roots.The root symptoms that arise in this case correspond to the level of the affected vertebral segment.Very often, the roots of L4-S1 are affected.
Vascular brown neurological disorders are caused by the compression of hernia in the column and the root artery that passes with it.At the same time, the "paralitic ishias" can be developed catastrophically, characterized by peripheral paysis or muscle paralysis paralysis.In such cases, the appearance of motor disorders is accompanied by the disappearance of pain.
The even more severe neurological manifestations are caused by a violation of the blood supply to the spinal cord due to the damage to the radical-space arteries.At the same time, chronic disorder myelopathy is developed, usually at the level of lumbar thickening of the spinal cord.
The most unfavorable version of lumbar vertical root syndromes is the compression of the "horse tail", the flow syndrome called So.Very often, it is caused by the fall of the middle hernia of the disc, which squeezes all the roots at the level of the affected segment.
What is the osteochondrosis of the lumbar column?What are your symptoms?How to treat lumbar osteochondrosis?
Clinical classification of osteochondrosis of the lumbar region.Degree of osteochondrosis
The classification of lumbar osteochondrosis according to grades is used for the systematic characteristics of the clinical manifestations of the disease.This classification systematically describes the symptoms of the disease and begins from the moment the patient has pain.
1 degree of osteochondrosis
It occurs when the intervertebral disc caused by an acute movement or an overvoltage.It is manifested by sudden pain, in the spine a sensation of electric current arises, the muscles are reflexively tense.
2 degrees of osteochondrosis
The second grade can manifest itself in the form of symptoms of intervertebral protuberance and instability of the spine.Chronic pain that increases in loads.The remission intervals and exacerbations alternate.The cervical region is characterized by the pain in the neck, increasing after a long stay in a position, headaches, hand pain, shoulder pain, periodic discomfort or numbness in the fingers.For the lumbar region: lumbar pain, pain in the gluteal region, periodic pain in the sacrum, frequent fatigue in the legs.
3 degrees of osteochondrosis
It manifests itself in the form of symptoms of the hernia of the intervertebral disc (Pain Along The Capfected Nerve, Numbness of the Arms Or Legs, A CHANGE IN GAIT, HEADACHES) or distant symptoms of the intervertebral hernia (in the Cervical Spine: Frequent Headaches, noise in the ears, dizziness, dizziness, dizziness, dizziness, dizziness,Decree in Vision, Muscle Strength in the Hands of the Thoracic: violation of the cordial region: heart rate violation, breathing difficulty;
4 degrees of osteochondrosis
In general, it is accepted that the fourth degree of osteochondrosis begins from the moment the hernia is no longer manifested, the manifestations of the disease can decrease, but the symptoms of spinal instability, slipping or twisting the vertebrae, or their complete fixation are still relative to each other.The manifestations of the growth of the vertebral bodies (osteophytes) can join them, which can also tighten the spinal nerves or overlap the spinal channel (secondary stenosis of the spinal channel) and tighten the spinal cord (ischemia of the spinal cord).In addition, the fourth grade includes the consequences of surgical intervention if the hernia was quickly eliminated (various types of innervation, paresis, inflammation).
Treatment of the osteochondrosis of the lumbar column
With the first sharp back pain, it is necessary to consult a doctor to establish a diagnosis to exclude a renal colic attack, appendicitis or any other disease that requires emergency medical care.
If the cause of back pain is known, and this exacerbation of the osteochondrosis of the lumbar column, in the first place, it is necessary to maximize the load in the spine.It is necessary to observe bed rest for 3 to 7 days, sometimes this can only significantly reduce pain.But to accelerate recovery, it is necessary correct, that is, an effective treatment.It should stimulate your own protection and health processes in the human body.The treatment must take into account the location of the lesion, the stage of the disease, the functional status of the body and its individual systems.The surgical treatment of this disease is indicated only in very serious cases.Most of the time, several methods of conservative treatment of osteochondrosis are used.
Conservative treatment of lumbar osteochondrosis
Conservative treatment methods are, first of all, pharmacological treatment.To reduce pain, as well as to reduce inflammation, which is often the cause of vertebral syndrome, non -steroidal anti -inflammatory drugs are prescribed in the form of tablets or, in acute cases, in the form of injections.Sometimes, after injection, an analgesic, pain calms down and does not resume even when the duration of the medicinal substance ends.This means that it was possible to break the vicious circle in which pain leads to muscle cramps, and muscle tension, in turn, improves pain.However, if pain lasts a long time, it is important to remember that NSAIDs generally have several side effects and with prolonged use can cause unwanted complications: a decrease in the number of leukocytes in the blood, complications of the gastrointestinal tract.
Often, sedative (soothing) agents are prescribed to improve the general condition of patients within 1-3 weeks, as well as small doses of antidepressants.With the osteochondrosis of the lumbar column, if necessary, a novocaine block is produced.Recently, anticonvulsive drugs began to be used successfully to relieve pain.
To reduce compression syndromes, manual therapy, traction treatment (spinal traction) and in special cases they are used: surgery.
When weakening the ligamentary apparatus and consistency of the spine, it is recommended to use fixing devices: corsets, necklaces, dressings, etc.However, only limited time of fixing devices can be used, since when used, muscles weakening is observed.And patients with spinal osteochondrosis are extremely important in the future to strengthen their own muscle corset.
After eliminating acute symptoms, the task of creating muscle fixation is first first and then stimulating the processes of regeneration of damaged structures.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use condoprotectors (medications to restore cartilage tissue).As well as drugs that improve the condition of blood vessels (angioprotectors), vitamins, mainly group B, calcium preparations that improve the condition of bone tissue.
For the treatment of the vertebral column osteochondrosis, physiotherapeutic procedures are widely used.They reduce pain and tissue edema, improve blood circulation and stimulate muscle fixation.The procedures can be combined, alternative.Such methods of physiotherapeutic treatment as:
- Darsonvalization of the affected area of the back and the affected limbs;
- electrophoresis;
- Low energy laser radiation;
- ultrasound;
- exposure to magnetic field;
- Thermal procedures.
Under sanitarium conditions, mud, ozokeritic applications, paraffin, radon, sulphide, hydrogen sulfide, treemine and other bathrooms are used successfully;
It should be remembered that for the development of total regeneration, it has a fairly long period of time, in favorable circumstances, occurs in the sixth month.Therefore, the treatment must be long.It must be carried out in a combined way, that is, medications combined with physiotherapy and physiotherapy exercises.