Many of us are aware of back pain, which disrupts normal life for a long time. Although the cause may be trauma, neurological disease or spinal malformations, lumbar spine osteochondrosis often causes unpleasant sensations. This degenerative disease can appear even at a young age, its initial manifestations can be detected even in adolescents and students, but most patients are people after 40 years. Spinal changes associated with osteochondrosis can occur anywhere from the cervix to the lumbar region and the coccyx. But the most common form that brings patients many unpleasant and painful sensations is osteochondrosis of the lumbar spine. What kind of pathology is this, what is characteristic of it and lower back pain always speaks of this disease.
Osteochondrosis of the lumbar spine: what is the essence of the pathology?
Osteochondrosis is a term derived from two words: the Greek osteon, which means bone, and the cartilage, which is cartilage. Thus, osteochondrosis of the lumbar spine (and everything else) begins with changes in the cartilage of the discs, which are the natural "lining" between the vertebrae and the shock absorber during movement. Changes in the structure of the disc and its functionality are accompanied by a natural reaction in the vertebral body. With this disease, degenerative changes appear gradually in the body of the discs. The height of the disc decreases, due to which it lost its normal function, causing instability and changes in the vertebral joints. As the disease progresses, a reaction occurs in the end plate of the vertebral body. This reaction can be divided into three stages: edema due to malnutrition and dystrophic changes, fatty degeneration and, in the last stage, hardening.
Causes of osteochondrosis of the spine
Our vertebral discs gradually begin to 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 (cartilage). This means that the disc can no longer act as a shock absorber and the tension in the anterior and posterior longitudinal ligaments of the vertebrae changes. As a result, a much greater load is imposed on the spinal joints, which increases from year to year. The vertebral joints are not properly positioned and are stretched unevenly and the moving parts of the spine gradually become unstable. The dorsal portion usually consists of two adjacent vertebral bodies and a disc between them. The upper and lower extremity plates in the vertebral body are subject to more stress, thickening zones (hardening) and the ridges (vertebrae) gradually develop. Due to these changes, the whole clinical picture of the disease is formed in the future.
What are the symptoms of osteochondrosis of the lumbar spine?
Almost any form of the disease manifests itself in the form of excruciating back pain, which is difficult to control and which affects a specific part of the spine (from the neck to the lower back and sacrum). Symptoms of lumbar spine osteochondrosis may remain limited to the spine (lumbar region) or spread to the legs if they come from the lumbar spine or the hands if they come from the cervical spine.
Symptoms may occur during rest, exercise, or normal activity. There may be radical symptoms caused by compression, irritation of the nerve root area, or pseudo-radical symptoms if the cause is in the facial joint or in the adjacent muscles. Often, osteochondrosis of the lumbar spine is combined with lesions in other areas - the thoracic, cervical spine - then the symptoms will be more widespread. In other words, the discomfort and pain are caused not only by one part that has been damaged, but by many areas of osteochondrosis at the same time. The disease has a wavy course with periods of exacerbation (symptoms can seriously affect normal life) and temporary remission, when the manifestations are reduced or almost disappear. But any factor, physical or mental, can lead to a sudden relapse.
How is osteochondrosis of the spine diagnosed?
The diagnosis is based on the study of the patient's medical history and complaints, the physical examination to determine the typical symptoms and the neurological examination. Today, doctors are increasingly tending to make diagnostic instruments, as other pathologies are often hidden under the guise of osteochondrosis.
For example, among patients suffering from persistent back pain who are planning surgery to relieve pain, bone health is an important factor. If a patient is found to have low bone density before surgery, this may affect the treatment plan for osteochondrosis before, during and after the procedure. A study by New York Hospital for Special Surgery (HSS) showed that computed tomography of the lumbar spine before surgery showed that a significant number of patients had undiagnosed low bone density.
Nearly half of the nearly 300 patients examined were diagnosed with osteoporosis or its precursor, osteopenia. It is especially important to consider this over the age of 50. The prevalence of low bone density in this group was 44% and 10. 3% were diagnosed with osteoporosis. Low bone density is a known risk factor for vertebral fractures and this condition can be an aggravating factor in the treatment of osteochondrosis.
Treatment of osteochondrosis of the spine
Treatment options depend on the severity of your symptoms. Physiotherapy is the main method of relieving pain in the early stages. Ultrasound, electrotherapy, heat treatment are used. Treatment is complemented by appropriate pain management such as NSAIDs, muscle relaxants and steroids. Injection practices can be used - exclusions, trigger point injections. Manual therapy, osteopathy, exercise therapy appear.
Surgical treatment is always the last resort. There are situations where surgery is required. An example would be paralysis of the bladder or rectum caused by narrowing of the spinal canal or elongated disc, a large disc with a hernia. The options for the operation are chosen in combination with the doctor. But after surgery, the problem is not completely eliminated, long-term rehabilitation and lifelong supportive treatment are required. This is due to the fact that osteochondrosis does not disappear anywhere, it can develop in other parts.