What is lumbar osteochondrosis?

Lumbar osteochondrosis is a pathology of the musculoskeletal system accompanied by degenerative dystrophic changes in bone tissue and impaired function of the five lower vertebrae (from 20 to 24 vertebrae). This disease causes discomfort to the patient and has specific symptoms - pain, stiffness of movement. Osteochondrosis of the lower back occurs in waves, with periods of exacerbation and remission. Statistically, this form is one of the most common. If the pathology is not taken seriously, it often results in irreversible changes and a significant deterioration in quality of life. However, with an effective comprehensive approach, osteochondrosis can be successfully treated.

Main causes of pathology

There are no definite data on why degenerative dystrophic changes in the spine are triggered. It is hypothesized that the initiating mechanism for the development of the pathology is age-related premature joint changes. They can be genetically determined - transmitted hereditary - but most often they manifest themselves initially under the influence of adverse factors.The primary one is thought to be improper load distribution on the spine. Lumbosacral vertebral osteochondrosis can occur in:

• wear high heels;
• Carry a bag or backpack on one shoulder and do not carry it alternately;
• Sleeping or resting in an uncomfortable position for long periods of time;
• Sedentary work;
• weightlifting.

People at risk for osteochondrosis include older adults who undergo natural destructive changes in cartilage and bone tissue, professional athletes who perform high-intensity training every day, and pregnant women who experience changes in their center of gravity as their fetus grows and the load on their lower limbs increases. The back is noticeably enlarged and office workers are forced to spend a lot of time in a sitting position.In addition to external risk factors, doctors also call it a set of internal risk factors. These include:

• Previous injury to the musculoskeletal system;
• curvature of the spine;
• flatfoot;
• Congenital hip dislocation or subluxation;
• autoimmune diseases;
• Inflammation of joint tissue;
• Pathology of the circulatory system;
• endocrine diseases;
• obesity.

Lower back osteochondrosis can also be caused by poisoning, chronic dehydration, bad habits, calcium deficiency, and any mechanical impact on the lower back (bruises, blows, falls).

Lumbar osteochondrosis: symptoms

The pathology affects not only the bone tissue itself, but also the entire spinal motion segment—the vertebrae, discs, ligaments, surrounding soft tissues, blood vessels, and nerve endings. Osteochondrosis of the lumbar spine develops gradually and slowly, its symptoms become apparent and the damage is significant. The early stage is moderate discomfort during exercise, and the later stage is acute unbearable pain. Clinical symptoms are more obvious in the acute phase. In remission, they gradually disappear, and in the early stages, this can happen even without treatment.Lumbar Osteochondrosis - Symptoms:

• Pain in the affected area of the spine;
• Pain radiating upward to the shoulder blade area or downward to the pelvis and hip joint;
• A persistent feeling of tension in the lower back;
• Difficulty bending and turning;
• slouch;
• limp;
• Muscle weakness or, conversely, increased tone;
• Tingling sensation.

Not all symptoms described always occur at the same time. Pain may be related to limited movement but not muscle weakness or numbness. Any of the above signs would be a reason to consult a doctor.

stage of disease

The severity of symptoms associated with lumbosacral vertebral osteochondrosis directly depends on the extent of the pathology. There are four in total.

1. Stage one. The first structural and functional changes begin. The discs become dry and may rupture. Symptoms at this stage are mild. Many patients mistakenly believe they are tired after a long day at work, wearing uncomfortable shoes, or exercising. The main symptom of early-stage osteochondrosis is mild discomfort in the lower back that worsens with bending and turning. There may be mild pain that subsides with rest.
2. The second stage. The height of the intervertebral discs decreases and the bone structure becomes closer. This can trigger a new wave of symptoms - stiffness and pain when moving. The pain becomes persistent and severe and may radiate to the pelvis and legs.
3. The third stage. During this stage, the vertebrae become deformed. Formation of a herniation - the disc bulges into the spinal canal area, but the annulus fibrosus remains intact. The main symptoms are severe pain that is disturbing even at rest, decreased sensitivity, a crunching sound when moving, tingling and numbness in the lower back.
4. The fourth stage. Pathological changes continue to progress. Loss of function of the vertebrae. Hernia form. Osteophytes (bone growths) form. Blood vessels may be squeezed and nerve fibers may be pinched. Against the background of worsening blood circulation, the function of the pelvic organs is disturbed. In men, the risk of erectile dysfunction is increased, and in women, disruption of the menstrual cycle is observed. Advanced osteochondrosis presents with severe low back pain, claudication, impaired mobility or even complete inability to move, and elevated body temperature.

If you are concerned about lumbar osteochondrosis, its treatment will depend directly on the stage of diagnosis of the disease. In the early stages, doctors have more recovery methods and techniques in their arsenal. Detection of degenerative dystrophic changes in their initial stages makes it possible to treat the pathology conservatively without resorting to surgical intervention.

pathological form

The classification of the types is based on the characteristics of the pain syndrome that is always associated with lumbosacral vertebral osteochondrosis. There are three in total:

1. Low back pain. It's a sharp stabbing pain that makes it impossible to move. The pain may be caused by pinched nerves or muscle spasms.
2. Lombardinia. It’s a long-lasting, heart-wrenching pain. It is characteristic of the stages of herniation and hernia formation. Additionally, discomfort may be related to ligament sprains.
3. Sciatica. This is a severe pain that radiates into the pelvic area. Patients complain of pain when walking, sitting, or changing body positions.

Two other pathological forms can be distinguished on the basis of accompanying symptoms. Patients may be diagnosed with:

1. Radiculopathy. It is accompanied by compression of nerve endings due to vertebrae deformation. With this disease, sensitivity is reduced and the affected area becomes numb. Shows soreness and tingling. Decreased muscle tone, impaired reflexes, and tingling in the legs may occur.
2. Discogenic lumbar osteochondrosis. This is a serious condition in which the patient's movements are restricted. His lower back and limbs were numb. Other symptoms include general weakness, fever, involuntary urination, and, if the condition persists, weight loss.

Risks of spinal disease

If left untreated, osteochondrosis not only brings excruciating pain and stiffness of movement, but also leads to many pathologies that develop in its context. Most common complications:

• intervertebral hernia;
• Inflammation of the sciatic nerve;
• Radiculitis;
• Paresis.

In order to prevent accompanying lesions, it is necessary to start treatment immediately from the moment osteochondrosis is discovered. With effective treatments, the destruction of bone and cartilage tissue can be stopped or significantly slowed.

Pathological diagnostic methods

Lumbosacral vertebral osteochondrosis must be distinguished from other lesions of the musculoskeletal system, which may present with similar symptoms. The first stage is a consultation with a neurologist, orthopedic surgeon, or surgeon. The doctor clarifies the chief complaint, collects a medical history, conducts a physical examination, and pays attention to the characteristics of the patient's posture and posture, the nature of work activities, bad habits, and accompanying diseases.For the most accurate diagnosis, use instrumentation technology:

• MRI;
• radiography;
• Contrast myelography;
• Multi-slice CT.

Each diagnostic procedure allows the physician to assess the condition of the lumbar and sacral spine at the current moment. The images clearly show structural changes in the vertebrae, indicating the stage of osteochondrosis. Based on the data obtained, experts decide on strategies for further management of the patient.Laboratory diagnosis is not critical, however, studies may be recommended if needed. In particular, if lumbar osteochondrosis is diagnosed, treatment can be based on the results of blood tests. They are necessary to elucidate the intensity of the inflammatory process in myofibers near the spine.

Lumbar Osteochondrosis: Treatment

The fight against pathology is carried out under the supervision of a neurologist and begins after a comprehensive diagnosis, when the extent and extent of tissue damage are determined. Modern medicine offers many effective conservative methods. If their use does not produce the desired results, doctors may resort to surgery.

Lumbar Osteochondrosis: Physical Therapy Approaches

All physical therapy techniques are good because they affect the sacrum and lumbar spine comprehensively. This approach can help you cope with pain, reduce inflammation, and restore normal circulation.When lumbar osteochondrosis progresses, comprehensive treatment should be performed. For patients with chief complaints:

• Electrophoresis - exposing problem areas to sustained electrical pulses and topical medications may be used;
• Dynamic therapy - a variation of electrotherapy using pulsed electric current;
• Magnetic therapy – treatment using alternating or static magnetic fields;
• Ultrasound therapy – the effects of high-frequency sound waves;
• Shock wave therapy - exposure to low-frequency sound pulses;

It is important to consider two nuances. Firstly, the effects of physiotherapy are only noticeable after a course of treatment, the duration of which is chosen individually for each patient. Second, physical therapy as an independent method is suitable for primary osteochondrosis. For large lesions, it is recommended as an auxiliary technique in addition to medical and surgical treatments.

Lumbar osteochondrosis: drug treatment

Pharmacological treatment of lumbar and sacral spinal lesions is aimed at relieving acute pain and suppressing the inflammatory process. This approach is suitable for the acute phase, when symptoms interfere with full life.How to treat lumbar osteochondrosis with medication is always a personal decision. Neurologists can prescribe medications from different pharmacological groups. Basic:

• NSAIDs (systemic and local) suppress inflammation of the vertebrae and adjacent tissues;
• Muscle relaxants to relieve muscle spasms;
• Vasoprotectants improve blood circulation;
• Chondroprotectant, protects intervertebral disc cartilage tissue from damage;
• B vitamins improve nerve conduction;
• Painkillers used to treat severe pain that limits mobility.

Exercise therapy as a treatment for sacral and lumbar regional pathologies

Intense training is strictly prohibited in patients with osteochondrosis, but physical activity cannot be completely abandoned. Instead, exercise of moderate intensity and duration can help restore circulation and reduce pain.How to treat lumbar osteochondrosis with exercise therapy:

1. Work out with a trainer. The trainer will show you which exercises are allowed in a given situation and ensure they are performed correctly. Even the smallest technical flaws can significantly reduce the effectiveness of training and even cause injury.
2. Prepare lessons carefully. Before exercising, it is recommended to warm up the muscles - you can gently massage the lower back and sacrum.  
3. Strict dosage. The lower back is a vulnerable area. To avoid overexertion, you need to monitor the duration of your sessions. Their optimal duration is no more than 20 minutes.
4. Gradually increase exercise intensity. For inexperienced beginners, simple exercises and short procedures are suitable. For those who have been doing exercise therapy for a while, you can move on to more sophisticated options.
5. Remember to be regular. A one-time workout won't lead to noticeable improvements. Pain in the lumbar and sacral spine is reduced if the patient undergoes exercise therapy regularly (ideally twice a week).
6. Consider contraindications. Physical therapy has been shown to be a safe method of treating osteochondrosis, but it does have limitations. You should stop exercising if you feel unwell: have a fever, weakness, or an elevated temperature.

Treatment of lumbar osteochondrosis should take into account the period of the disease and will not bother you if all rules are strictly followed.

1. in the acute phase. Only smooth and slow movements are allowed. If the pain gets worse during exercise, you need to stop and let the joint rest.
2. In the subacute stage. The pain syndrome subsides and mobility returns, so the intensity and duration of training can be slightly increased. However, to avoid deterioration, you need to monitor your health carefully.
3. In remission. We allow a full range of exercises for lumbar spine pathology, but it is important to remember that overexertion can lead to new exacerbations of the disease.

If lumbar osteochondrosis is diagnosed as mild or moderate, physical therapy can also be performed at home. After you have perfected your practice skills under the guidance of a coach, you are not prohibited from repeating the practice at home. To train, you will need a gymnastic mat, a roller, and a ball. Modern sports therapy and rehabilitation rooms are equipped not only with traditional accessories, but also with special medical simulators. They can help you recover from illness gently and safely and make activities more fun and interactive. For example, the Neuromuscular Rehabilitation System turns recovery into an exciting race against the self. The patient stands on the moving platform and performs the exercises displayed on the screen. Another important advantage of simulators is the ability to track even the slightest progression of a patient's condition. The system evaluates the results of each exercise, and doctors can see how each session is progressing. Understanding one's own successes also motivates patients to try harder and not give up.

manual therapy

Good results can be achieved if exercise therapy and drug therapy for lumbar spine pathology are combined with manual therapy. This method allows:

• Eliminates excessive tension in muscle fibers;
• pain relief;
• Restores blood supply to the lumbar and sacral areas;
• Improves metabolic processes.

Manual therapy is an effective way to correctly redistribute the load on the spine and protect yourself from further damaging changes. The benefit of this method is that it not only relieves pain, but also prevents neurological diseases caused by lumbar osteochondrosis.  Currently, chiropractors combine massage and physical therapy methods such as tecartherapy. Electromagnetic waves penetrate deep bone tissue, giving you pain relief and a quick return to mobility.  

surgical method

Treatments for lumbar osteochondrosis, including medications, physical therapy, and exercise, are not always effective, making the patient's life very complicated. In some cases, only surgical intervention can eliminate pain and restore back mobility. Modern methods and technical equipment make minimally invasive surgeries and shortened recovery periods possible.For osteochondrosis, the following interventions are relevant:

• Endoscopic herniectomy - using microsurgical instruments and a built-in camera;
• Transfacet resection of intervertebral hernia - using a neurosurgical tube dilator;
• Laminectomy – surgical removal of pathologically altered bony prominences;
• Microdiscectomy – eliminates hernia.

Direct indications for surgical intervention are recurrent hernias, spinal stenosis (narrowing of the spinal canal), and degenerative spondylolisthesis (a pathology in which the vertebrae are displaced relative to each other). In all other cases, if lumbar osteochondrosis is diagnosed, doctors will try to treat it using conservative methods.

disease prevention

The symptoms of osteochondrosis can be inconvenient, and treatment of the pathology can take a long time. It will be more effective to protect your fragile waist from overexertion in advance. For preventive purposes it is recommended:

1. Arrange your workplace properly during office work. The chair back should support the lower back and the table should be at the right height.
2. Avoid wearing uncomfortable shoes. The optimal heel height for women is 5 cm. It is also recommended to exclude flat shoes as they can lead to foot deformation and flat feet - this is one of the factors.
3. Risk of osteochondrosis.
4. exercise. Lifting heavy objects should be avoided. Swimming, walking and aerobic exercise are all useful if there are no contraindications.
5. Eat a balanced diet. Foods that must include calcium, phosphorus and B vitamins in your diet include fish, dairy products, green leafy vegetables and grains. These substances are needed to strengthen all parts of the joints and support the nervous system.
6. Make sure you get enough sleep. It’s best to sleep on a medium-firm orthopedic mattress. It will provide anatomically correct posture, insulating the body from daily stress.
7. Control your weight. Obesity is one of the predisposing factors. If the weight is normal, the load on the spine is adequately distributed and the risk of circulatory diseases is minimized.

The prognosis of patients with osteochondrosis depends directly on the extent of the vertebral damage. This is why prompt diagnosis is extremely important. If you are concerned about low back pain and the images show the initial stages of a destructive process, you need to start treatment. In the early stages, medications and physical therapy are effective. In later cases, it is almost impossible not to have surgery. Exercise therapy can be used as an additional adjunct in any form and at any stage.