Many of us are familiar with back pain that disrupts normal life for a long time. Although the cause may be trauma, neurological diseases or malformations of the spine, osteochondrosis of the lumbar spine often becomes a provocateur of unpleasant sensations. This degenerative disease can appear even at a young age, its initial manifestations can be found even in adolescents and students, but the majority of patients are people over 40 years. Changes in the spine associated with osteochondrosis can occur in any part, from the cervical to the lumbar and sacrococcygeal. But the most common form, which brings patients a lot of unpleasant and painful sensations, is osteochondrosis of the lumbar spine. What kind of pathology is this, what is typical for it and whether the pain in the lower back always speaks of this disease.
Osteochondrosis of the lumbar spine: what is the nature of the pathology?
Osteochondrosis is a term derived from two words: Greek osteon, which means bone, and chondron, which is cartilage. Thus, osteochondrosis of the lumbar spine (and all others as well) is initiated by changes in the cartilage of the discs, which are the natural "lining" between the vertebrae and the shock during movement. Changes in the structure of the disc and its functionality are accompaniedfrom a natural reaction in the body of the spine. In this disease gradually occur degenerative changes in the body of the discs. The height of the disc decreases, due to which its physiological function is lost, causing instability and changes in the spinal joints. With the disease progressing in the end plate ofbody reaction of the spine occurs. This reaction can be divided into three stages: edema due to malnutrition and dystrophic changes, fatty degeneration and in the last stage sclerosis.
Causes of osteochondrosis of the spine
Our spinal discs begin to gradually deform and change when we are about 20 years old. The gradual reduction of fluid in the body of the disc leads to a reduction in the size of the space between the vertebrae (chondrosis). This means that the disc can no longer function as a shock absorber and the tension in the anterior and posterior longitudinal connections of the vertebrae changes. As a result, the spinal joints are subjected to a much greater load, which increases from year to year. The spinal ligaments are not positioned correctly and are unevenly stretched, and the movable segments of the spine gradually become unstable. The dorsal segment usually consists of two adjacent vertebral bodies and a disc between them. The upper and lower end plates in the body of the spine are subjected to greater stress, the areas of compression (sclerosis) and gradually develop ridges along the borders (spondylophytes). Due to such changes in the future the whole clinical picture of the disease is formed.
What are the symptoms of osteochondrosis of the lumbar spine?
Almost every form of the disease manifests itself in the form of excruciating back pain, which is difficult to control and which affects a certain segment of the spine (from the neck to the waist and sacrum). Symptoms of osteochondrosis of the lumbar spine may remain limited to the spine (in the lumbar region) or spread to the legs if they come from the lumbar spine, or the arms if they come from the cervical spine.
Symptoms may occur during rest, exertion, or normal activity. There may be radicular symptoms caused by compression, nerve root irritation, or pseudoradicular symptoms if the cause is in the facet joint or adjacent muscles. Often osteochondrosis of the lumbar spine is combined with lesions in other areas - the thoracic, cervical spine - then the symptoms will be wider. In other words, discomfort and pain provoke not only one segment that is damaged, but several areas of osteochondrosis at once. The disease has a wavy course with periods of exacerbation (symptoms can seriously interfere with normal life) and temporary remissions, when the manifestations decrease or almost disappear. But all factors, physical or mental, can lead to a sudden relapse.
How is spinal osteochondrosis diagnosed?
The diagnosis is based on a study of the patient's medical history and complaints, a physical examination to identify typical symptoms, and a neurological examination. Today, doctors are increasingly inclined to perform instrumental diagnostics, as other pathologies are often hidden under the guise of osteochondrosis.
For example, among patients suffering from persistent back pain and planning surgery to relieve pain, bone health is an important factor. If the patient is found to have low bone density before surgery, this may affect the osteochondrosis treatment plan before, during and after the procedure. A study by the Special Surgery Hospital (HSS) in New York showed that computed tomography of the lumbar spine before surgery showed that a significant number of patients had low bone density that had not been diagnosed before.
Almost half of the nearly 300 patients tested were diagnosed with osteoporosis or its precursor osteopenia. It is especially important to take this into account over the age of 50. The prevalence of low bone mineral density in this group is 44%, and 10. 3% are diagnosed with osteoporosis. Low bone density is a known risk factor for vertebral fractures and this condition may be an aggravating factor in the treatment of osteochondrosis.
Treatment of osteochondrosis of the spine
Treatment options depend on the severity of your symptoms. Physical therapy is the main method of relieving pain in the early stages. Ultrasound, electrotherapy, heat treatment are used. Treatment is complemented by appropriate combination pain management, such as NSAIDs, muscle relaxants and steroids. Injection practices can be used - blockades, trigger point injections. Manual therapy, osteopathy, exercises are shown.
Surgical treatment is always the last resort. There are situations when surgery is needed. An example of this could be paralysis of the bladder or rectum caused by narrowing of the spinal canal or a prolapsed disc, a large disc herniation. The options for the operation are chosen together with the doctor. But after surgical treatment the problem is not completely eliminated, long-term rehabilitation and lifelong maintenance treatment is needed. This is due to the fact that osteochondrosis does not disappear anywhere, it can progress to other departments.