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 both men and women, manifests itself in the form of pain concentrated in the sacral region, reflected in its symptoms in the lower extremities, which is often independently defined by patients as “pinched lumbar nerve.”
General description
Most often, the form of osteochondrosis under consideration develops against the background of back injuries and a sedentary lifestyle; accordingly, people whose particular professional activities involve loads affecting the back are automatically at risk for the possibility of developing this disease.And this is not only office workers, who, of course, belong to this group, but also loaders, builders, service workers (waiters, for example), drivers, etc.
An important role is also played by the factor of heredity in the context of considering 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 pain of varying degrees of severity, which can be aching, occurring after sleep or after being in the same position for a long time (during prolonged sitting, standing), as well as shooting and sharp.In the latter version, they arise as a result of prolonged adoption of a not very comfortable posture with the simultaneous impossibility in such a situation of implementing actions aimed at straightening up, thereby eliminating such a posture along with the load it provides.Painful sensations themselves arise as a result of pinching under the corresponding influence of the nerve roots, as well as irritation of the nerves in the spinal column, irritation of the ligaments and muscles (concentrated within the area 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 most often the course of the disease is combined 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 (irradiation) of pain can be noted to the thighs and buttocks, as well as to the legs (from their outer surface).
The term used to define osteochondrosis in its more expanded version (degenerative-dystrophic lesion), relevant for the intervertebral disc, actually implies a significant in its diversity complex of pathological conditions directly related to various types of structures of the spine (spinal column), namely discs, joints and osteophytes.The same problems that relate directly to disc damage are its protrusion and discogenic pain. Types of osteochondrosis and areas of concentration.
Protrusions in lumbar osteochondrosis
Protrusions in this area of interest to us develop most often; moreover, it is protrusions that cause pain in the lower back.The lumbar region itself, given its location and features, is most susceptible to the occurrence of certain functional problems.
That is, when considering this statement from one side, we can highlight that our center of gravity directly relates specifically to the lumbar region, and accordingly, it bears a significant part of the loads.When viewed from the other side, one can notice that a significant range of movements, again, falls precisely on this lumbar region.Taking this into account, the greatest tendency to damage (as well as to the protrusions we are interested in) occurs precisely on the discs concentrated in the lumbar region.In addition, we must not forget that changes in discs in this and, of course, other areas also occur against the background of age-related degenerative processes.
Let us remind our readers what protrusions actually are.The connection of the discs to each other in the spine is ensured by discs based on cartilage tissue.The main components of the intervertebral disc are the nucleus pulposus and the fibrous ring, through which fixation within the vertebral disc is ensured.The influence of certain factors and conditions provokes the possibility of rupture of this ring, against the background of which, in turn, protrusion of the nucleus occurs.As a result of this process, a hernia develops.As for protrusion, it is already developing as a result of a similar process, but without the accompanying rupture of the ring - in this case it is simply subject to thinning and not rupture, because the nucleus protrudes directly through the ring.Actually, this protrusion is defined as protrusion.
As for the symptoms of protrusion, it manifests itself in the following:
- feeling of stiffness in the lower back;
- pain in the lumbar region;
- chronic lower back pain;
- lumbosacral radiculitis;
- numbness, pain, tingling in the toes, feet;
- dysfunction of urination (in rare cases of the pathology in question).
Conservative treatment is mainly used for lumbar disc protrusion.Meanwhile, protrusions that are significant in development are often accompanied by severe symptoms that are 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 intensity variations.So, these can be aching pains that appear mainly after sleep or after a long period of sitting, or there can also be shooting pains that are sharp in their manifestation.Moreover, the manifestation of the latter is often noted at the moment of occupying an uncomfortable position without the ability to straighten up.Any type of pain is directly related to the effect on the nerve endings, muscle swelling, irritation and pinching to which the nerve roots are exposed.Pain is also associated with irritation of the lumbar ligaments in the area of 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 noted in certain areas (skin, lower half of the body, leg muscles).It is also possible that the tendon reflexes in the legs will weaken or disappear completely.As a rule, it is osteochondrosis that provokes the development of curvature in 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 arching back;
- 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 defecation or urination disorders, disorders associated with sensitivity in the genital or perineal area.
As a rule, pain appears (and also worsens) as a result of the impact produced during physical activity.A painful reaction in this case can be observed both after this load and after some time from the moment of its impact.Basically, patients' complaints in this regard boil down to the appearance of dull and 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 with shaking, changing the position of the body, 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 manifests itself in the inability to carry out actions aimed at straightening up or moving.Any movement is accompanied by increased pain.In addition, even if the patient spends a short time in cold conditions, he experiences acute lumbar pain (which is also defined as “lumbago”).
Symptoms of lumbar osteochondrosis also appear in the following:
- impaired sensitivity in the thighs, buttocks, legs, and feet (which is noted somewhat less frequently);
- spasm of the arteries of the feet, increased chilliness of 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 occurs against the background of osteochondrosis is vertebral instability, in which the disc ceases to properly fix the vertebra.This, in turn, provokes a “slipping” under the influence of gravity of the lumbar region from the sacrum when the load is placed on the lumbar region.As a result of this, not just unpleasant disturbances may develop, but dangerous disturbances affecting the functioning of internal organs.The genitourinary system “suffers” in particular; this manifests itself in men as problems with potency, and in women as problems relating to the appendages, uterus and ovaries.
Manifestations of lumbar osteochondrosis
In accordance with the most complete classification, a number of specific syndromes that are relevant for lumbar osteochondrosis are identified.In particular, these include the following syndromes:
- reflex syndromes - these include lumbar ischalgia, lumbodynia and lumbago;
- radicular syndromes – vertebrogenic (or discogenic) sacrolumbar radiculitis, the course of which is accompanied mainly by damage to the first sacral root or the fifth lumbar root;
- radicular-vascular syndromes - radiculoischemia manifests itself as a process of vascular compression (in particular, veins or arteries are subject to compression), while compression is performed simultaneously with the root.
Let us briefly outline what the listed syndromes are.
Lumbodyniain particular, it means chronic pain that occurs gradually after a long period of taking an uncomfortable position with the body or after prolonged sitting, as well as after the impact exerted on the body and a specific area after physical activity.
Lumbagomanifests itself in the form of acute lumbar pain, characterized as a “lumbago”; lumbago mainly occurs when lifting heavy objects or when a movement is unsuccessful.Sometimes lumbago is also observed after coughing or sneezing.
Diseases that accompany lumbar osteochondrosis
Lumbar osteochondrosis occurs not only in combination with pain and other listed symptoms, but also in combination with some characteristic diseases of the internal organs.
Thus, about more than 30% of patients with clinical symptoms relevant to 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 provokes, along with pain impulses, tension in blood vessels and muscles and spasm, resulting in a state of oxygen starvation with the simultaneous development of a degenerative process in certain areas of the body.The process is aggravated by metabolic disorders, which are inherent in this type of disease.
In addition, as we noted earlier, lower back pain can provoke the development of diseases in the pelvic organs.Women may encounter a disease such as inflammation of the appendages (which is 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 area, which develop as a result of the above diseases, including chronic colitis, hemorrhoids and constipation.
Treatment
Mostly, the treatment of osteochondrosis is multicomponent and quite complex in its implementation.Mostly all treatment measures come down to the following points:
- drug treatment;
- if necessary, surgical treatment;
- diet;
- physical therapy.
An exacerbation of the disease requires, first of all, the patient to remain in bed.The main recommendation for this part is a hard/hard sleeping place.Extremely pronounced attacks require minimal physical activity and prompt consultation with an appropriate specialist.The appearance of symptoms indicating the possible relevance of lumbar osteochondrosis requires contacting a neurologist.