Lumbar osteochondrosis is one of the most common forms of the underlying disease, osteochondrosis itself.Lumbar osteochondrosis, the symptoms of which are equally defined in men and women, manifests itself in the form of pain concentrated in the sacral region, which is reflected in its symptoms in the lower extremities, often independently defined by patients as a "pinched lumbar nerve".
General description
Most often, the considered form of osteochondrosis develops against the background of back injuries and a sedentary lifestyle;therefore, people whose particular professional activities involve loads affecting the back are automatically at risk of developing this disease.And it's not just office workers, who of course belong to this group, but also shippers, builders, service workers (e.g. waiters), drivers, etc.
The hereditary factor also plays an important role against the background of thoracic osteochondrosis.Here, not much, not little, but about 60% of the probability is present if the disease is present in close relatives.The rest is influenced by environmental factors that, to one degree or another, influence the spine.
Lumbar osteochondrosis, like its other forms, is characterized by more or less severe pain, which can be aching, occurring after sleep or after being in the same position for a long time (in prolonged sitting or standing), as well as throbbing and acute.In this last version, they result from the prolonged adoption of an uncomfortable posture with the simultaneous impossibility in such a situation of implementing actions aimed at straightening up, thus eliminating such a posture as well as the load it provides.The painful sensations themselves arise from pinching under the corresponding influence of the nerve roots, as well as irritation of the spinal nerves, irritation of the ligaments and muscles (concentrated in the zone of innervation, that is, the actual location of the nerves of the region in question that control it) and swelling.
It is important to note that in isolated form this type of osteochondrosis is extremely rare, and therefore the course of the disease is most often associated with the symptoms inherent in cervical osteochondrosis, which we will consider in our next article.
The general and earliest symptom, relevant for all forms of osteochondrosis, as we have already noted, is the manifestation of pain, which in this case is determined by a specific localization, that is, pain in the lower back.The spread (radiation) of pain can be seen in the thighs and buttocks, as well as in the legs (from their outer surface).
The term used to define osteochondrosis in its broader version (degenerative-dystrophic lesion), relevant for the intervertebral disc, actually implies a significant complex in its diversity of pathological conditions directly related to various types of spinal structures (spine), namely discs, joints and osteophytes.The same problems directly related to disc damage are its protrusion and discogenic pain.Types of osteochondrosis and areas of concentration.
Protrusions in lumbar osteochondrosis
The protrusions in this area that interests us develop most often;Moreover, it is the protrusions that cause pain in the lower back.The lumbar region itself, given its location and characteristics, is most susceptible to the appearance of certain functional problems.
That is, considering this statement from one side, we can emphasize that our center of gravity relates directly specifically to the lumbar region and, therefore, it bears a significant part of the loads.Seen from the other side, we can notice that a significant range of movement, again, falls precisely on this lumbar region.Taking this into account, the greatest tendency to damage (as well as to the protrusions that interest us) occurs precisely on the discs concentrated in the lumbar region.In addition, we must not forget that disc changes in this and, of course, other areas also occur against the background of age-related degenerative processes.
Let's remind our readers what protrusions actually are.The connection of the discs to each other in the spine is ensured by discs made from cartilaginous tissue.The main components of the intervertebral disc are the nucleus pulposus and the annulus fibrosus, through which fixation within the vertebral disc is ensured.The influence of certain factors and conditions causes the possibility of rupture of this ring, against the background of which in turn occurs a protrusion of the core.As a result of this process, a hernia develops.As for the protrusion, it develops already as a result of a similar process, but without accompanying rupture of the ring - in this case it is simply subject to thinning, and not rupture, since the core protrudes directly through the ring.In fact, this protrusion is defined as a projection.
As for the symptoms of protrusion, they manifest themselves in the following way:
- feeling of stiffness in the lower back;
- pain in the lumbar region;
- chronic lower back pain;
- lumbosacral radiculitis;
- numbness, pain, tingling in toes, feet;
- urination dysfunction (in rare cases of the pathology in question).
Conservative treatment is mainly used in cases of lumbar disc protrusion.Meanwhile, developmentally significant lumps are often accompanied by severe symptoms resistant to treatment;in this case, surgical intervention is no longer possible.
Lumbar osteochondrosis: symptoms
Pain in this form of osteochondrosis manifests itself in various variations in intensity.So, it may be aching pains that appear mainly after sleep or after a long period of sitting, or there may also be shooting pains, the manifestation of which is acute.In addition, the manifestation of the latter is often observed when occupying an uncomfortable position without the possibility of straightening up.Any type of pain is directly related to the effect on the nerve endings, muscle swelling, irritation and pinching that the nerve roots are exposed to.The pain is also associated with irritation of the lumbar ligaments at the level of the innervation of its nerve endings.
Increased pain in the lower back in this form of osteochondrosis is observed when coughing and sneezing, including during body movements (especially when bending forward).
Lumbar osteochondrosis can also manifest itself, in addition to lower back pain, also in the form of sensory disturbances observed in certain areas (skin, lower half of the body, leg muscles).It is also possible that the tendon reflexes in the legs weaken or disappear completely.As a rule, it is osteochondrosis that provokes the development of curvature of the lumbar spine.
Based on the specific plane of the actual curvature, osteochondrosis is divided into the following types:
- kyphosis - in this case there is a flattening of the lumbar region, and often its back arches;
- lordosis - the spine bends forward;
- scoliosis – the spine is curved to the left or right.
Pinching of the roots belonging to the spinal cord as a result of the development of osteochondrosis within the lumbar region is often determined in the form of a number of specific disorders, namely disorders of defecation or urination, disorders associated with sensitivity in the genital or perineal region.
As a rule, pain appears (and also worsens) as a result of the impact produced during physical activity.In this case, a painful reaction can be observed both after this load and after a certain time from the moment of its impact.Basically, patients' complaints in this regard boil down to the appearance of a dull, aching pain in the lumbar region, and in some cases it radiates to the leg, which is defined as lumbodynia.In addition, there may be complaints of pain in the leg with its intensification when trying to lift something heavy (lumbago).The same applies to sneezing and coughing, driving while shaking, changing body position as well as staying in the same body position for a long time.
As a result of an exacerbation of the disease in question, there is a constant and pronounced tension in the back muscles, which is manifested by the inability to perform actions aimed at straightening or moving.Any movement is accompanied by increased pain.In addition, even if the patient spends little time in the cold, he experiences acute lower back pain (also defined as “lumbago”).
Symptoms of lumbar osteochondrosis also appear as follows:
- impaired sensitivity of the thighs, buttocks, legs and feet (which is observed somewhat less frequently);
- spasm of the arteries of the feet, increased feeling of cold in the legs;
- tingling sensation in the legs, “goosebumps”;
- peeling and dry skin in an area where there is usually loss of sensation or pain;
- sweating disorders.
The most unpleasant complication that arises against the background of osteochondrosis is spinal instability, in which the disc ceases to properly fix the vertebra.This, in turn, causes "sliding" under the influence of gravity of the lumbar region relative to the sacrum when the load is placed on the lumbar region.As a result, not only unpleasant disturbances can develop, but also dangerous disturbances affecting the functioning of internal organs.The genitourinary system particularly “suffers”;this manifests itself in men as potency problems and in women as problems related to the appendages, uterus and ovaries.
Manifestations of lumbar osteochondrosis
In accordance with the most comprehensive classification, a number of specific syndromes relevant to lumbar osteochondrosis are identified.These include the following syndromes:
- reflex syndromes – these include lumbar ischalgia, lumbodynia and lumbago;
- radicular syndromes – vertebrogenic (or discogenic) sacrolumbar radiculitis, the development of which is mainly accompanied by lesions of the first sacral root or the fifth lumbar root;
- radicular-vascular syndromes - radiculoischemia is manifested by a process of vascular compression (in particular, veins or arteries are subjected to compression), while compression is carried out simultaneously with the root.
Let us briefly describe what syndromes are listed.
Lumbodyniein particular, it is a chronic pain that appears gradually after a long period of uncomfortable position with the body or after prolonged sitting, as well as after the impact exerted on the body and on a specific area after physical activity.
Lumbagomanifests itself in the form of acute lower back pain, described as “lumbago”;Lumbago mainly occurs when lifting heavy objects or when a movement fails.Sometimes lumbago is also observed after coughing or sneezing.
Diseases that accompany lumbar osteochondrosis
Lumbar osteochondrosis occurs not only in association with pain and other listed symptoms, but also in association with some characteristic diseases of internal organs.
So, approximately more than 30% of patients with clinical symptoms associated with lumbar osteochondrosis note the presence of certain problems associated with the liver or the functions of the gastrointestinal tract.The fact is that the presence of a particular disease of the gastrointestinal tract, pancreas or liver causes, along with painful impulses, tension in blood vessels and muscles and spasms, leading to a state of lack of oxygen with the simultaneous development of a degenerative process in certain areas of the body.The process is aggravated by the metabolic disorders inherent in this type of disease.
In addition, as we noted earlier, lower back pain can provoke the development of diseases of the pelvic organs.Women may face such a disease as inflammation of the appendages (defined as adnexitis), and men, in turn, experience all the "delights" of prostatitis, that is, inflammation of the prostate gland.
Manifestations of lumbar osteochondrosis are also accompanied by congestive phenomena in the pelvic region, which develop as a result of the above diseases, including chronic colitis, hemorrhoids and constipation.
Treatment
Most often, the treatment of osteochondrosis is multicomponent and quite complex in its implementation.Most treatment measures boil down to the following points:
- drug treatment;
- if necessary, surgical treatment;
- diet;
- physiotherapy.
An exacerbation of the disease requires, above all, that the patient stay in bed.The main recommendation for this part is a place to sleep rough/hard.Extremely pronounced seizures require minimal physical activity and timely consultation with an appropriate specialist.The appearance of symptoms indicating a possible relevance of lumbar osteochondrosis requires contacting a neurologist.