Osteochondrosis is the most severe form of degenerative -district lesion of the spine, which is based on the loss of the pulpic nucleus of the intervertebral disc, with subsequent deformities of the bodies of the nervous system and blood and toddlers.
One of the most common forms of osteochondrosis is osteochondrosis of the lumbar region, or, more precisely, the lumbosacral poles.For many - both men and women - are familiar with back pain in the lower back, sacrum, lower extremities, caused by different types of lumbar osteochondrosis and its complications.Among the reasons for temporary disability and disability, this disease occupies one of the first places.
The course of the disease is chronic, usually with periods of irritation.Most often, the osteochondrosis irritations of lumbar lumbar ligament and the transfer of weights, hypothermia, stress and damage are provoked.
Osteochondrosis of the lumbar spine - the causes, the mechanism of emergence and development
There was no blurred cause of osteochondrosis, the disease is considered polyfaver.The most popular theory is, according to which the cause of spinal osteochondrosis is constant muscle predominance or muscle hypotension, non -physiological muscle tension, which leads to overload of vertebral segments, which is the result of which is the result of which is the result of which is the result of which is the result of which is the result of which is the result of which is the result of which is the result of which is the result of the result.Osteochondrosis.
The cause of premature aging of the intervertebral discs can also be endocrine and metabolic disorders, an inherited predisposition to the development of osteochondrosis, autoimmune disorders and microtrauma.The negative role of visceral, that is, associated with internal organs, pathology in the development of osteochondrosis of the spine, is also proven.An important role in the development of the disease belongs to the unfavorable heritage.The contribution of inherited factors to the emergence of lumbar osteochondrosis is about 60%, the rest refers to factors of adverse external influence on the back.
Factors that contribute to the development of osteochondrosis in both Lumbar and other parts of the spine are many.Most importantly: improper behavior, hypodynamia, overlap of muscles in the lumbar region as a result of constant weighting of weights or a sharp excessive load, hormone restructuring, endocrine and somatic disease, normal blood supply in spinal tissue, emotional stress, linked changes.Under the influence of these factors on spinal structures, dehydration processes and circulatory disorders, arthrosis and subluxation in small joints, bone growth and discs - hernias are gradually increasing.
The most obvious causes of lumbar osteochondrosis are most often considered a sedentary lifestyle and back damage.Therefore, the risk group mainly includes those people whose profession is directly related to the loads on the back.This is a very wide range of professions - seller and waiters, surgeons and teachers - all those who are forced to spend most of their work time.The risk group includes builders and motifers, as well as athletes who, in the nature of the activity, arise large loads on their backs.Moreover, drivers, various office workers, programmers - that is, those who have mostly sitting work, and who suffer from the hypodynamia, suffer from Lumbar's osteochondrosis.
Symptoms of osteochondrosis of the spine
onlumbar osteochondrosisThe painful sensations of different nature are possible.This can be either pain of pain that occurs with an extended place or after sleep, as well as sharp purposes, causing the most unpleasant position and preventing the possibility of being directed.The pain adheres from the nerve roots, the irritation of its nerves of the spinal column, edema and irritation of the muscles and ligaments located in the inner area of the lumbar back.
Pain syndrome can be caused by the compression of radicular structures (radiculopathy), compression of the spinal cord (compression myelopathy), spinal cord damage due to damaged blood supply due to narrowing, narrowing (stenosis) of the supply arteries and veins).
The reason for the compression may be: the extension and hernia of the intervertebral discs, spondylolistz (vertebra slipping in relation to the foundation), increased osteophytes and cartilage tissue in the vertebral segment.As a resultOsteochondrosis of the lumbar regionThe spine leads to the narrowing of the canal through which the cerebrospinal nerves or vascular structures pass, and under certain conditions (difficult movement, physical activity, an unsuccessful body twist, etc.) can occur, compression.Compression of nerve structures leads to various pain syndromes, muscle spasms.Compression of the blood vessels causes a violation of blood supply - the ischemia of the organ that is fed by this vessel or artery begins.
Clinical osteochondrosis syndromes of the lumbar spine
The clinical photography for lumbar osteochondrosis is determined by a complex of vertebral symptoms (a change in spinal static and dynamics) and associated symptoms, which are understood as a violation of the function of neurological and vascular structures in the lumbosacral region.
Vertebral syndromes of lumbar osteochondrosis
With lumbar osteochondrosis, vertebral syndrome is characterized by the following complex of symptoms:
- Violation of functional-anatomical spinal segment configuration: an increase in lordosis, scoliosis or lordoskoliosis is observed;
- Violation of mobility in the lumbar region, a decrease in volume of movements, muscular-tonic imbalance caused by the tension of multi-inhuman and superficial muscles;
- local pain and pain with active and passive motion, which causes tonic muscle reflex tension;
- violation of the functions of the intervertebral disk source and, in general, vertebral-motor segment;
- Local pain (increased sensitivity) of bone-ligamentous structures of the spine in the affected area (pain during palpation, local vertebral (regional) vertebral and/or vertebrosonal pain syndrome).
It is important to note that with the osteochondrosis of the lumbar department, vertebral pathologies are always observed.The presence of signs of myelopathy, radiculopathy and myeloradiculopathy without obvious clinical and morphological signs of vertebral syndrome requires, as a rule, a higher examination of the patient for primary damage ("no -superster") in the nervous system.
Expervertebral syndromes (reflex and compression) for lumbar back osteochondrosis
Extrovertebral syndromes are divided into two major groups: reflex and compression.
Reflex syndromesThey precede compression and are caused by irritation of the nerve root receptors coming out of the spinal canal through intervertebral holes.Irritation can be caused by intervertebral hernia, bone growth, as well as vascular disorders (edema, circulatory deterioration) and inflammation.In some cases, this leads to intense pain, which occurs not only in the country but also during the course of the nerve at a distance from the site of irritation -so -called "reflected pain", reflected pain can be short and acute ("change") or stupid.In the area of impaired nerve intrigue, vegetative disorders (burning, goosebumps, damaged sensitivity) are possible.Myophassic pain is possible - muscle spasm, which leads to restriction of movements.
Reflex syndromes include lumbago ("Shift") in acute development of disease and lumbalgia with subacute or chronic course.
Compression syndromes are syndromes that occur as a result of compression, nerve violation, blood vessels, spinal cord in the lumbar spinal segments.Compression syndromes for lumbosacral department osteochondrosis are divided into radicular and vascular-brown.A special case of compression syndrome is myelopathy - spinal cord violation.
Medication syndromes (radiculopathy) are usually due to disk extensions, causing violations of cerebrospinal roots.The radicular symptoms that arise in this case correspond to the level of the affected vertebral segment.Most often, L4-S1 roots are affected.
Disordishes vascular-brown neurological disorders are caused by the compression of hernia in the spine and the root artery that passes with it.At the same time, the "paralytic Ishias" can develop catastrophically, characterized by peripheral paresis or paralysis of the muscles of the foot extensors.In such cases, the appearance of motor disorders is associated with the disappearance of pain.
Even more severe neurological manifestations are caused by a violation of blood supply to the spinal cord due to damage to the radicular-curing arteries.At the same time, chronic distinctive myelopathy develops, usually at the level of lumbar thickening of the spinal cord.
The most unfavorable version of vertical lumbar radicular syndrome is the compression of the "horse tail" - the so -called caudal syndrome.Most often, it is caused by the declining medinal hernia of the disk, which squeezes all the roots at the level of the affected segment.
What is lumbar spine osteochondrosis?What are its symptoms?How to treat Lumbar's osteochondrosis?
Clinical classification of lumbar region osteochondrosis.The degree of osteochondrosis
The classification of lumbar osteochondrosis by degrees is used for systemic characteristics of clinical manifestations of the disease.This classification systematically describes the symptoms of the disease and starts from the moment the patient has pain.
1 degree of osteochondrosis
Occurs when the intervertebral disc caused by a sharp movement or overvoltage occurs.It is manifested by a sudden pain, in the back a feeling of passage of electric current arises, the muscles are reflexively tense.
2 degree of osteochondrosis
The second degree can be manifested in the form of symptoms of intervertebral extension and spinal cord instability.Chronic incremental pain in loads.Remission intervals and irritations alternate.The cervical region is characterized by pain in the neck, growing after a long stay in a position, headache, hand pain, shoulder pain, periodic discomfort or numbness in the fingers.For the lumbar region - lower back pain, pain in the gluteal region, periodic pain in the sacrum, frequent leg fatigue.
3 degree of osteochondrosis
It manifests itself in the form of symptoms of intervertebral disc herniation (pain along the affected nerve, numbness of the arms or legs, a change in walks, headaches) or distant symptoms of intervertebral hernia (at the back of the cervix: head callers, noise in the ears, designs, decreased vision.of thokus of thokus thokus of thokus of throat's thokus frame: Cortor's creation: Cortor Creator: Cortor Cortor: Heart rhythm violation, difficulty breathing;
4 degree of osteochondrosis
It is generally acknowledged that the fourth rate of osteochondrosis begins from the moment hernia no longer manifests, manifestations of the disease may decrease, but the symptoms of spinal instability, sliding or distortion of vertebrae, or their full fixation are still relatively relatively with each other.Manifestations of growth of vertebral bodies (osteophytes) can join them, which can also squeeze the spinal nerves or overlap the spinal canal (secondary spinal canal stenosis) and squeeze the spinal cord (spinal ischemia).Moreover, the fourth degree includes the consequences of surgical intervention if the hernia was immediately removed (different types of intrigue, paresis, inflammation).
The treatment of osteochondrosis of the spine
With the first acute acute back pain, it is necessary to consult a physician to create a diagnosis in order to exclude an attack of renal colic, appendicitis or any other disease that requires urgent medical care.
If the cause of back pain is known, and this deterioration of lumbar spine osteochondrosis, first of all, is necessary to maximize the load on the back.It is necessary to observe the bed rest for 3 to 7 days - sometimes only this can significantly reduce the pain.But to accelerate recovery, it is necessary correct, that is, effective, treatment.It should stimulate its protective and health processes in the human body.Treatment should take into account the localization of the lesion, the stage of the disease, the functional state of the body and its individual systems.The surgical treatment of this disease is indicated only in very severe cases.Most often, different methods of conservative osteochondrosis treatment are used.
Conservative treatment of lumbar osteochondrosis
Conservative methods of treatment are, above all, treatment of medicines.To reduce pain, as well as to reduce inflammation, which is often the cause of vertebral syndrome, non -steroidal anti -inflammatory drugs (NSAIDs) in the form of tablets or - in acute cases - in the form of injections are prescribed.Sometimes, after injection, an analgesic, the pain calms and does not resume even when the duration of the medicinal substance ends.This means that it was possible to break the evil circle in which the pain leads to muscle pain, and muscle tension, on the other hand, increases the pain.However, if the pain lasts for a long time, it is important to remember that NSAIDs usually have different side effects and with prolonged use can cause unwanted complications - a decrease in blood leukocytes, complications from the gastrointestinal tract.
Often, soothing agents (soothing) are prescribed to improve the overall condition of patients within 1-3 weeks, as well as small doses of antidepressants.With osteochondrosis of the lumbar spine, if necessary, the blockade of the novocaine is produced.Recently, anticonvulsants drugs began to be used successfully to relieve pain.
To reduce compression syndromes, manual therapy, withdrawal treatment (spinal withdrawal) and in special cases surgeries are used.
When weakening the properties of fixing the ligamentous apparatus and the consistency of the spine, it is recommended to use fixed equipment - corset, collar, clothing, etc.However, only limited time can be used fixed equipment, since when used, muscle weakening is observed.And patients with spinal osteochondrosis are extremely important in the future to strengthen their muscle corset.
After removing acute symptoms, the task of creating muscle fixation comes first in the first place, and then stimulate the regeneration processes of damaged structures.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use chondroprotectors (medicines to restore cartilage tissue).As well as medicines that improve the condition of blood vessels (angioprotectors), vitamins, mainly group B, calcium preparations that improve bone tissue condition.
For the treatment of spinal osteochondrosis, physiotherapeutic procedures are widely used.They reduce tissue pain and edema, improve blood circulation and stimulate muscle fixation.Procedures can be combined, alternative.Such methods of physiotherapeutic treatment as:
- darsonvalization of the affected area of the posterior and affected limbs;
- electrophoresis;
- low -energy laser radiation;
- ultrasound;
- exposure to the magnetic field;
- Thermal procedures.
Under conditions of sanatorium, mud, ozokerity, paraffin applications, radon, sulfide, hydrogen sulfide, turpentine and other baths are successfully used;
It should be remembered that for the development of complete regeneration, it takes a very long period of time, in favorable circumstances occurring in the sixth month.Therefore, the treatment should be long.It should be performed in a combined way, ie, medicines combined with physiotherapy and physiotherapy exercises.